A riddle sautéed in a mystery deglazed with an enigma
July 11, 2021 10:01 AM   Subscribe

The obesity epidemic is deeply weird. For example: lab animals are getting fatter, even if they're eating the same diet that animals were fed decades ago. People living at higher altitudes are significantly less prone to becoming overweight than people who reside at lower elevations.

Many explanations have been offered to account for the epidemic, but none are adequate to explain all the data, and there is good evidence against all of them. So what now?
posted by alex1965 (153 comments total) 98 users marked this as a favorite
Widespread obesity is the most critical health concern facing the rich world now, more than cancer. It's not just the weight itself it's the comorbidities: heart disease, diabetes, muscle and bone problems, etc. It's possible to be overweight and healthy in other respects but for a lot of people, being overweight seems causative of other systemic problems and a shorter lifespan.

One day we're going to figure this out. It's going to turn out to be some complicated systemic response but there will be one basic causative thing that can be altered: something about the gut microbiome, or processed carbohydrates, or some weird synthetic chemical we're all inhaling without realizing. It's going to seem like a magic solution. As a middle aged overweight guy starting to have some other systemic problems related to that, I only hope it happens in my (possibly shortened) lifespan.

(Malaria is still one of the most critical health concerns facing the world as a whole. And we have solutions for that!)
posted by Nelson at 10:09 AM on July 11, 2021 [18 favorites]

That column reminds me of planning notes for a dystopian novel...except that it's Real Life. * sigh*
posted by wenestvedt at 10:18 AM on July 11, 2021 [3 favorites]

That map is wow. I wonder how it correlates with poverty.
posted by Mitheral at 10:32 AM on July 11, 2021 [4 favorites]

Should I bother offering an argument against the idea that obesity is an "epidemic" in the same way as, say, cancer?

The way much of society discusses this topic is shameful. I would expect better at Metafilter frankly. I'm already feeling angered enough at the way this was framed, that I will not read the linked article. I am an obese PERSON, emphasis on person. If we were talking about the health risks of smoking, we wouldn't say there is a "smoker's epidemic". The risk is in the behavior, not in the person. My obese body is not part of an epidemic. And in fact, I resent being pushed to label it "obese", I am fat. I am not a medical condition, I am a person with bigger fat cells than some.

I do think there are some health risks that come with a certain level of obesity, but:

* Being slightly "overweight" is actually associated with better health. The best health on average seems to be around a BMI of 27.
* Interesting then that the medical industry redefined overweight and obesity a few years back so that more people would fall into those categories. Maybe they did the same with lab animals.
* Some of the bad health effects of obesity are no doubt due to the stress of living as a fat person in this society, as well as due to poorer medical care (even by self-report, doctors treat fat patients worse than thin ones). We know that prolonged stress is not good for the health. We know that poorer social connections are not good for the health. We know that not going to preventative checkups because you are tired of being treated like shit by doctors is not good for the health.

If you are not fat yourself, please treat this discussion with care and act like you are talking about a disadvantaged group of PEOPLE, because you are.
posted by Flock of Cynthiabirds at 10:34 AM on July 11, 2021 [144 favorites]

This is a very interesting topic. The headline frames the link in a way that reinforces fatphobic tropes, and contradicts the article, which indicates that science doesn't know why we're getting fatter, but it's not that we eat more.

Let's steer this thread in a direction that shows respect for people at all sizes.
posted by latkes at 10:39 AM on July 11, 2021 [52 favorites]

I'm the OP. For whatever it's worth, my BMI is over 30, making me clinically obese.
posted by alex1965 at 10:40 AM on July 11, 2021 [38 favorites]

A new study finds that people today who eat and exercise the same amount as people 20 years ago are still fatter

That said, I wonder how much of what are considered to be the effects of obesity are actually the results of fatphobia and diet culture. Fat people, especially fat women, are often shamed while at the gym, at the beach, walking down the sidewalk--in other words, they are discouraged from exercising. Being fat-shamed causes stress--and often triggers binge-eating.

The health issues of fat people (especially women) are often ignored (because the answer is always 'lose weight' even if it's a condition known to cause weight gain) and medical professionals are often nasty enough to discourage fat people from seeking out care (preventative or otherwise) in the future. If a fat person suddenly starts losing weight, the doctor might not look into the cause because they believe weight loss is always good (happened to my mother-in-law--she had cancer).

And then there are the diets and drugs. Constantly losing and then gaining back weight is hard on the body. Diets like the keto diet can damage your organs. Don't forget the thousands of people who took fen-phen and may be living with permanent damage to their hearts.

I'm going to end this with a recommendation for the podcast Maintenance Phase. They cover wellness and diet culture in a humane way.
posted by LindsayIrene at 11:07 AM on July 11, 2021 [51 favorites]

I found this fascinating and prima facie convincing. The author seems to know what they're talking about. But then I have this reaction where I imagine summarizing the argument to my spouse or at a dinner party or whatever and I'm like "No, I didn't read this in a New York Times or New Yorker or Guardian summary of a Lancet article. I didn't hear it on NPR or ever read it on Slate or Vox. I read it in a blog post by an anonymous science blogger with a funny name!" Because when people who explain new ideas to me that they have encountered by reading anonymous science blogs, my response is often skepticism.

I suspect that this is way too obvious as a stab at the mystery these posts sets up, but the last time I kept a food diary was for a mandatory health class in college and it was a massive lie because I left out the 500-1000 daily calories I was getting from beer. I wonder how many calorie estimate studies are based on food diaries and if people lie (or forget/overlook hidden calories) in their food diaries more than they did fifty years ago.
posted by sy at 11:13 AM on July 11, 2021 [13 favorites]

If we were talking about the health risks of smoking, we wouldn't say there is a "smoker's epidemic".

We absolutely do talk about the "tobacco epidemic". The WHO says:
The tobacco epidemic is one of the biggest public health threats the world has ever faced, killing more than 8 million people a year around the world.
posted by Klipspringer at 11:14 AM on July 11, 2021 [54 favorites]

I wonder if it has something to do with the plastics and chemicals that have infiltrated the entire food supply and natural world. I can't imagine it's good to have microplastics and such basically in every system of your body. I know that's a little ~spooky chemicals~ but I feel like in 50 years we're going to feel about (something) the way people do today reading about doctors like "Why, what you need is a smoke a day, that'll perk you right up!"

For the record, I am obese as all hell and found it fascinating, not triggery or upsetting. I mean he literally says "Dieting doesn't work" at the bottom of the first section" and the top of the second section dismantles the beloved "calories in, calories out" talking point.
posted by Ghostride The Whip at 11:20 AM on July 11, 2021 [69 favorites]

Can we start the conversation by acknowledging that perhaps multiple things can be true at the same time? That the points the author is making all do point to some kind of mystery surrounding obesity that has picked up steam over the last 100 years AND that there are social forces like fat phobia that also contribute to some (most?) of the poor health comes associated with obesity? Like two things can true at the same time right? Especially something as complex as human health at both the individual and popoulation levels?
posted by flamk at 11:21 AM on July 11, 2021 [50 favorites]

(I am a relatively 'normal'-bmi person; I'll focus on population level statistics and BMI-as-a-number in this comment. Feel free to ping me if that's not an appropriate approach.)

I found this to be a fascinating read, focused on the statistics, repeatedly giving counter-evidence to common explanations of increases in BMI. Their end-point, after knocking down many other hypotheses, is the lipostatic theory, which posits that there's a system in the body for increasing/decreasing fat stores to meet a particular BMI, and that societal increases in BMI are caused by this mechanism being (somehow) out of whack. This seems like a great explanation for population-level increases in BMI, given that simple cause/effect hypotheses don't seem to hold water.

The only problem is that there's little understanding of how the posited lipostatic system actually works. There was apparently a molecule called leptin discovered in 1994 which may be part of the puzzle, but administering leptin doesn't seem to have much effect on BMI. Research is ongoing into how lipostatic regulation actually works. On the bright side, if it's solved we'll likely get a diet in a pill, and (hopefully) some understanding of what's causing the imbalance in the first place. (eg, turns out molecule X is important, but somehow getting blocked... so then you just need to look for X blockers in all of the plastics we're inadvertently eating.)

(and yeah, the article I linked is a scientific article on lipostatic mechanisms, for others who might be interested or want a slightly more reputable-looking thing to cite in discussions with friends. :P )
posted by kaibutsu at 11:22 AM on July 11, 2021 [16 favorites]

I thought the article was fascinating and not judgmental in any way, only indicating that people now have much higher BMIs than they used to, and animals do as well, and that there is no conclusive evidence for any specific cause, including eating too much or not exercising enough. For those who are worried about reading it, I can't recommend the article enough.

The thesis is new enough to me that I did wonder if the author was forgetting something, but then it would be addressed in the next paragraph, and everything is cited so I suppose it could all be looked up and checked.

It will be interesting to see if this way of looking at the rise of BMIs in humans and animals takes hold.
posted by maggiemaggie at 11:26 AM on July 11, 2021 [11 favorites]

Thank you, kaibutsu!

For better or for worse, and I realize the danger of derailing here, this blog also contains a post that I very strongly disagree with about how having a senate that grossly overrepresents rural whites is a brilliant idea, something I've thought about a fair amount over the years. Without being able to point any specific holes in the argument, I confess to getting a Gell-Mann Amnesia Effect feeling that maybe this bold contrarian take on obesity has some hole in it that I can't see.
posted by sy at 11:26 AM on July 11, 2021 [13 favorites]

I wonder if it has something to do with the plastics and chemicals that have infiltrated the entire food supply and natural world. --Ghostride The Whip

Chemicals in plastic definitely affect our hormone system, and studies have found a link from this to obesity.
posted by eye of newt at 11:32 AM on July 11, 2021 [19 favorites]

I'm already feeling angered enough at the way this was framed, that I will not read the linked article

It's not at all a shaming exercise; I thought it was very interesting. I suggest you give it a go.
posted by Joe in Australia at 11:37 AM on July 11, 2021 [18 favorites]

I agree with the OP's key point: Obesity trends are deeply weird and unexplained. And this is a highly sensitive topic that makes it hard to untangle medicine/nutrition/biology from sociological factors.

I'm not a nutritionist, a biologist or a sociologist (although I'm French, and therefore legally obligated to comment on ze bad diets of other people). That said, Flock of Cynthiabirds and other posters are right: There is something wrong about the slant in these articles: To start with, unless a key, but invisible event took place in 1976, it is highly unlikely that BMIs all started rapidly increasing, just like that, all of a sudden. The charts in the first article are shocking, not because of the increase in obesity, but the suddenness of the change. McDonalds, Coca-Cola and Froot Loops did not suddenly get force-fed in 1976. Far more likely there is a statistical flaw in the methodology (undoubtedly combined with some aspect of increasingly unhealthy lifestyles) that is causing obesity to be *measured* as trending higher. Either that or the data-set is wrong.

In 1976, Apple was founded and Voyager reached Mars, so it's possible that an alien pathogen was sent to Earth to glue us to screens and stop properly metabolizing sugars and fats. On the other hand, reductions in tobacco and alcohol consumption, combined with rising inequality and social stresses, could be driving another impact on metabolism. The fact that unhealthy processed foods were available before 1976 confounds the issue, but perhaps it's not the basic type of nutrients (fat, carbs, etc) but the reliance on processed versus unprocessed foods that is driving the change. Equally, pollution likely plays a role, since CO2/Oxygen balance plays a role in metabolism.

Coincidentally, the wealthier people are, the longer-lived, taller, thinner and healthier they are, and by some other incredible coincidence, the more unprocessed their diets and less polluted their environments (and vice versa for poor people).

It would be interesting (and I'm sure some enterprising Mefite has done already) to correlate obesity with social factors such as wealth, wealth inequality, pollution, physical exercise, stress, depression, reality television or videogaming consumption, party affiliation, etc. Perhaps that might lead to more compassionate analyses than "why are people getting so fat"?
posted by Bigbootay. Tay! Tay! Blam! Aargh... at 11:40 AM on July 11, 2021 [21 favorites]

Our diets may be largely unchanged but I doubt that the water we drink is unchanged.

How many of us drink water from fridge dispensers which are built using plastic hose and whose internal storage units are entirely plastic?
posted by simra at 11:50 AM on July 11, 2021 [6 favorites]

Far more likely there is a statistical flaw in the methodology (undoubtedly combined with some aspect of increasingly unhealthy lifestyles) that is causing obesity to be *measured* as trending higher. Either that or the data-set is wrong.

I wouldn't be so sure about that. The steady increase in BMI over the last fifty-ish years would require a steadily more wrong methodology, wouldn't it?

An alternative plausible explanation is that some particular new chemical ramped up to large-scale industrial application around that time, or started finding new application in food storage. The leaded gas epidemic is perhaps a good reference point here: it was notoriously hard to measure because it affected basically everyone. Likewise, DDT came under heavy scrutiny and was taken out of circulation in the 70's, and we had other chemicals that caused the o-zone hole. There were piles of terrible chemicals coming into circulation across the 20th century, and it seems easy to imagine that we 'missed' at least one with a large scale effect.
posted by kaibutsu at 11:52 AM on July 11, 2021 [26 favorites]

My money is on our gut microbiome having a much greater impact on our health than we currently suspect. Decades of antibiotics and nutritional changes and other scientific advances have dramatically altered our microbiome over the last two centuries in ways that are now between hard and impossible to ascertain.
posted by Mr.Encyclopedia at 11:54 AM on July 11, 2021 [24 favorites]

Thanks for posting this, it is thought-provoking.
This is obviously complex. I was most surprised by the detail about the lab animals, but then I realized that they probably aren't feeding lab rats organic heirloom vegetables, so they are getting pesticides and weirdly genetically enhanced foods with lower nutritional value than before 1970. And those are one aspect of the rise in obesity, I think. But I think there are other aspects too.
Personally, since I was a teenager, I have sometimes gained weight when I struggled with mental health issues, such as depression and anxiety, but it isn't really that simple. For the most part of my life, I have been very, very skinny, and sometimes I have been depressed or anxious without putting on weight. During those years of being very thin, I have eaten everything, starch, fat, protein, sugar, you name it. And I ate a lot. It was a joke at my job that I could eat two big sandwiches and a cake for lunch day after day without any weight gain. Contrariwise, I struggled with problems related to my low BMI, like early menopause (which I managed to reverse by gaining some weight).
For the last twenty years, I have become increasingly obese. I think I can see a pattern, but I am not a doctor, and I don't want to post my personal issues and random theories here. But I will say that I am very interested in the whole gut microbiome thing.
posted by mumimor at 11:57 AM on July 11, 2021 [5 favorites]

Mod note: Hey, mod here with a reminder to both (a) take care in how you approach a charged topic especially where it affects groups you don't belong to, and (b) to try and keep this more focused on the actual content of the link instead of the broad dive into The Discourse in general. It sounds like there's a lot of interesting stuff in the article that isn't the same tired tropes, so this'll probably go best if the conversation can focus on that.
posted by cortex (staff) at 11:58 AM on July 11, 2021 [16 favorites]

What about wild animals though? If it were microplastics, then we'd most definitely see this going up the natural food chain.
posted by polymodus at 12:00 PM on July 11, 2021 [8 favorites]

The OP article links to evidence of increased cross-species obesity:
Abstract: A dramatic rise in obesity has occurred among humans within the last several decades. Little is known about whether similar increases in obesity have occurred in animals inhabiting human-influenced environments. We examined samples collectively consisting of over 20 000 animals from 24 populations (12 divided separately into males and females) of animals representing eight species living with or around humans in industrialized societies. In all populations, the estimated coefficient for the trend of body weight over time was positive (i.e. increasing). The probability of all trends being in the same direction by chance is 1.2 × 10−7. Surprisingly, we find that over the past several decades, average mid-life body weights have risen among primates and rodents living in research colonies, as well as among feral rodents and domestic dogs and cats. The consistency of these findings among animals living in varying environments, suggests the intriguing possibility that the aetiology of increasing body weight may involve several as-of-yet unidentified and/or poorly understood factors (e.g. viral pathogens, epigenetic factors). This finding may eventually enhance the discovery and fuller elucidation of other factors that have contributed to the recent rise in obesity rates.
posted by kaibutsu at 12:04 PM on July 11, 2021 [9 favorites]

There are several psychological/social/economic/environmental things to consider. The level of perceived risk that people experience at a local level (close proximity) has been significantly reduced for large swathes of the population. This reduces the need for flight or fight scenarios. Despite opportunities available to many (not all), mobility is not as great - as in movement from one location to another or even one room to another - and opportunities to eat food of many levels of quality surround us - vending machines, street carts, 'fast' food, supermarkets etc. The supply chain has allowed the delivery from farm to mouth to be set at a ridiculously low level both in terms of access and the processing of raw materials.

Look at any flyer from a supermarket and note the widespread promotion of 'bad' foods with low production cost and high profit margins due to the economy of supply of cheap ingredients. Corn and soy bean make up a large percentage of food ingredients in the US. Add to this that it's quite likely that most of the diseases of modern civilization, major depression, heart disease and obesity are linked to the radical and dramatic shift in the composition of the fats in the food supply in the past thirty to forty years.

Whether we know it or not (read labels PLEASE) most of us are eating too many of the wrong types of sugar (NOTE: not going down the HFCS rabbit-hole as places like Mexico have low HFCS consumption but have high levels of obesity). What we eat is a key element here. How our bodies react to this varies, but for most people it leads to weight gain. Before Covid (BC) "In the United States, eating food out at a restaurant or ordering it for takeout/delivery has become increasingly popular. For the ten years leading up to 2019, food and drink sales in the United States restaurant industry steadily increased and reached over 773 billion U.S. dollars in 2019." See here for stats. Just take a look at the drive thru at most fast food places... Food portions are another issue with the size of an average restaurant serving and plate being large than those typically used in a home.

Environmental issues abound - the amount of chemicals introduced to the environment through the use of glyphosates, plastics, fungicides in food production, housing, furniture, clothing... all of these have grown dramatically in the the past 50 years. Movement of the body has also reduced with easy access to transport. Heating and cooling of homes means temperature variance is minimized. The stress related from living in close proximity to others - increases in city living and dense suburban environments.

Personally, I see most of the ground root causes being related to the above and in particular to Big Agriculture, Big Food Corporations, and a lack of will from Government/s to do anything to address the issues which would impact the profits of the aforementioned groups. Psychological impacts of advertising also have a high level of blame... "Go on! Treat yourself! You know you deserve it." being one of the most egregious ones I have seen, along with variants of that message. Celebratory acts are now incorporated into the food chain beyond the big Christmas/Thanksgiving feasts to incorporate extra opportunities for food sales..

People have been accepting crappy food and incorporating it gladly into their diets for too long. You are what you eat... remember that.
posted by IndelibleUnderpants at 12:05 PM on July 11, 2021 [5 favorites]

With regard to the theory that chemical contaminants may be contributing to obesity: There's a precedent, of sorts. Hyperthyroidism in cats used to be an exceedingly rare condition. Now it's very common (which I know from personal experience, being a long-time cat-lover). There's a theory that flame retardants are to blame. The hyperthyroidism epidemic seems to have started sometime in the late 1970s or early 80s.
posted by alex1965 at 12:07 PM on July 11, 2021 [20 favorites]

Then, of course it could be that humans are simply being farmed by an alien race who are chomping their lips at the soon to be harvested culinary delights of Farm Planet Earth.......
posted by IndelibleUnderpants at 12:09 PM on July 11, 2021 [5 favorites]

The thing that's wild about this is that "obesity" is measured by BMI, not body fat percentage. For so many of these studies, so many of these statistics, they're not even looking at the right thing.

Many, many athletes are both trim and "obese" because they have a lot of muscle. What if increased nutritional content (combined with societal preferences for body types changing) is leading people to trend "bulkier" than in the past?

We've definitely observed that increased nutrition has lead to increased average height (though that's somewhat plateaued), but it seems entirely overlooked that it could lead to an increase in average body mass such that the BMI trends higher without any necessary decrease in health or increase in fat percentage.
posted by explosion at 12:10 PM on July 11, 2021 [19 favorites]

Ye gods, that "Trends in adult overweight, obesity, and severe obesity" graph is a travesty. What the heck is going on with the x-axis? Worse, it's like that in the original. I assume this is because the survey was administered at irregular intervals, but at a quick glance, it makes it look like 1976-1980 was a weird inflection point.

The tables on that CDC page also present biennial data from 1999 onward, which shows the same upward trend in age-adjusted prevalence. The tables break down by gender and race/ethnicity as well, the latter of which is a pretty good indicator that you're looking at social determinants rather than biological determinants of health.*

* I do also wonder about the influence of epigenetics, which are poorly understood (at least, by me) but seem to be one mechanism by which social conditions exerts generational influence. Thinking specifically here about the Dutch Hunger Winter of 1944-1945; people who had been exposed to famine in utero were much more likely to be overweight or obese as adults, compared to their older/younger siblings, and there's some suggestion that the effects have impacted the next generation as well.
posted by basalganglia at 12:12 PM on July 11, 2021 [21 favorites]

Americans actually ate more calories in 1909 than they did in 1960.
They also did a lot more physical exercise. No cars, no modern kitchen conveniences or farm machinery. If you look at a photo of a baker from back then, they had huge arms from working the dough.

The article also doesn't mention how processed modern food is compared to for back then. I'm not saying some things aren't weird, but there are some obvious things not mentioned.
posted by CheeseDigestsAll at 12:17 PM on July 11, 2021 [20 favorites]

Very interesting article. I agree there's no body-shaming going on in the linked pieces.

A couple-plus years ago, I cut alcohol (lots of it!) out of my diet completely. I also started working a semi-manual labor job 40 hours a week. I still eat whatever I want and I have lost over 30lbs. I have noticed that being active like this has also (weirdly) lowered my appetite. I still get hungry, but a smaller meals are just more appealing to me now. I often find myself sated by less food these days. When I began my physical job, I was bringing lunch to work, which was usually leftovers or a sandwich, some fruit and potato chips. I like potato chips quite a bit. I found that my old "normal" quantity of chips was tasty and satisfying, but it was giving me gas and upset stomach. It took me a while to realize that if I ate fewer chips, I didn't get gas and wasn't uncomfortable in the afternoons. Now I cannot imaging eating my old "normal" serving of chips. I've recently started eating only half a sandwich many days, and adding some other snacks mid morning and mid afternoon. My point is I was basically on autopilot, eating what I thought I wanted/needed which led to discomfort and not feeling great. And in retrospect, it took a curiously long time for me to realize this.

It's apparent that there's many—perhaps hundreds—of factors going on with this topic. I appreciate this post.
posted by SoberHighland at 12:33 PM on July 11, 2021 [12 favorites]

This article is better written and more nuanced than its headline gives it credit for. It even acknowledges that BMI isn’t a useful measure of adiposity on the individual level. (I do wish it emphasized more that the whole point of it was to serve as a shortcut for measuring population trends.)

I appreciate that it approaches another hard truth, which is that (whatever its comorbidities) obesity isn’t something that can be “cured” by just body-shaming people harder. (Let alone the uncomfortable fact that there is virtually no BMI at which a girl or woman hasn’t been loudly body-shamed for being “fat,” and when that shaming resulted in weight loss it was often enough the terminal kind.)

I was declared “fat” (“normal” weight per my doctor, but precocious female puberty + toxically misogynistic environment) around age 9. I’m now a 39-year-old who restricts food intake and exercises several times harder/more scientifically than your pork-eating farmer grandpa ever did, just to maintain a “normal” weight. (This is my choice, and not what I’d expect anyone else to do.) I think it’s probably worth exploring the impacts of endocrine disrupters, hormonal responses to situational/environmental stressors, and access to preventive healthcare/decent nutrition/adequate exercise AND rest.

As the article points out, some trends are global, but the US has been at the leading edge for decades, and there it remains. For instance, perhaps it’s time we stopped mocking the French for their abbreviated work week, while we snack just to stay awake through ours (because our insurance is tied to it).
posted by armeowda at 12:35 PM on July 11, 2021 [12 favorites]

Many explanations have been offered to account for the epidemic, but none are adequate to explain all the data, and there is good evidence against all of them

(clicks link)

ctrl-F endocrine disrupt

(not found)

Uh huh.
posted by flabdablet at 12:47 PM on July 11, 2021 [10 favorites]

explosion, I think you need to look around. And compare with those old film strips that show street life a hundred years ago. That said, you also have a point, the reason it was hard for me to get any treatment for my underweight back in the nineties was that my doctor was fixated on my normal BMI rather than my emaciated appearance and early onset menopause.

Back to the articles. Like CheeseDigestsAll, I feel that the author passes very lightly over the fact that those lab rats put on a lot more weight on the breakfast menu. To me, that points to the complex formulas of highly processed food as a big culprit. On the other hand, I have almost not eaten highly processed food for 35 years, since it was discovered that I have an allergy that is almost always triggered by processed food, and still I am fat today.

Since the first corona lockdown in March 2020, I have been keeping a diary, and some time last summer, I made a non-judgmental spreadsheet recording what I eat. Since I know that my mental health and my weight are somehow connected, I felt one way to help myself would be to register what I eat. And this morning, when I read the article I linked above, I tried to count the amount of fibre and the variation in my food. I have to say, I do not get a lot of fibre, and I do not get a lot of variation (though I am better at variation than at fibre). So from this morning on, I'm working on those factors.

The article compares intake of carbs and sugars to previous generations and other cultures, but I think they are not being quite rigorous enough. A hundred years ago, most people were not eating soft white bread on a daily basis, and even "white" bread and pasta definitely contained more whole grains than today. Just back when I was a child, 50 years ago, a soda pop was a treat, not a daily occurrence. Coca Cola existed, yes, but one would only have it as a treat, when the adults got their wine or beer as a treat, too. The economy of food plays a big part here, and I think it is really strange that the author ignores this entirely. I only eat fast food when I am driving long distances, and the other day I stopped at a MacDonalds on the road. It was cheaper for me to buy larger quantities of Coca Cola and fries with my burger. How can one say no to that? I persuaded myself that I would trash the excess amounts, but I didn't. In theory, a burger and a small handful of fries is actually not bad for you, though it isn't health food. There are very few additives, and a good balance of nutrients. But if you eat double the amount of what you need, and add in a liter of sugar water, well, then you are back to your obese base.
posted by mumimor at 12:47 PM on July 11, 2021 [14 favorites]

Ye gods, that "Trends in adult overweight, obesity, and severe obesity" graph is a travesty. What the heck is going on with the x-axis?

The graph might be a mess, but it does a pretty good job of pointing up how profoundly weird the situation is: the overweight percentage is essentially flat, but obesity is increasing sharply. It's really hard to come up with an intuitive explanation for that.
posted by multics at 12:49 PM on July 11, 2021 [3 favorites]

a key, but invisible event took place in 1976 ... McDonalds, Coca-Cola and Froot Loops did not suddenly get force-fed in 1976

From This is how portion sizes have changed over time:
since the 1970s the average size of foods from fast-food chains, restaurants and grocery stores has increased by 138%.
I remember 1979, my first time at a restaurant co-workers at my new job enjoyed, where they served sandwiches which seemed almost as big as my head. "Take the rest of it home in a doggy bag, for later" they said -- but many of us (including me) accepted the challenge and finished up our sandwiches on the spot.
posted by Rash at 12:50 PM on July 11, 2021 [5 favorites]

I don't think this article looks nearly closely enough at CO2, it cites just one example of a Navy submarine study done in the 80s – they do have an extreme amount of CO2 there, but they're also all fitter-than-the average-person armed forces personnel on regimented diets, a narrow range of ages, and only on board for a relatively short period of their lives.

I think there needs to be more research on pregnancy and multi-generational exposure to high CO2 levels. We can do comparison studies with rats over generations, it seems obvious to me that raising several generations of rats from the same gene stock in low-CO2 environments (simulating pre-industrial air) and high-CO2 environments would be a really valuable study but I haven't heard of anyone doing anything like that. If you've seen something like that let me know, I'm more involved in the ocean ecology side of climate change but I don't really read many lab rat studies or terrestrial animal studies at all.
posted by 100kb at 12:51 PM on July 11, 2021 [20 favorites]

Part 3 of the series is as yet unpublished. I expect that, as noted by commenters above, it will point out that there is clearly some evidence for influence of the gut microflora on obesity (see here and here). I think this is at least one contributory cause. Changes in commercial agriculture and food production (the rise of factory farming, changes in meat production, use of antibiotics or other putative subtle toxins in agriculture, and so on) are also highly suspect, imo; of course, these two factors could be and likely are interrelated. A whole raft of environmental toxins have also been proposed (PFAS/PFOS, etc, etc).

Growing up in the South US, obesity was already common and remarkable (to me) in the 60s and 70s compared to my years in CO and OR in the same period. But now it seems a more widespread problem in the US. More recent travels in Japan, the Philippines, and Indo suggest the problems is much less in these countries. This may be cultural, genetic, epigenetic (microflora again), or due to differences in commercial food production.

Anyway, interesting post.
posted by sudogeek at 12:54 PM on July 11, 2021 [4 favorites]

But then, given that I work in climate change I do tend to look at CO2 as the first potential culprit whenever something weird and bad has started happening over the last few decades.
posted by 100kb at 12:54 PM on July 11, 2021 [3 favorites]

Oh yes, the use of antibiotics in food production is bound to be a huge factor, and it will play a bigger role in countries where meat is a larger part of the diet. So yes, Masai people eat a lot of protein, but they don't give their herds a lot of antibiotics.
I mean, one of the reasons farmers feed their livestock antibiotics is that it promotes growth.
posted by mumimor at 1:00 PM on July 11, 2021 [5 favorites]

The article does not mention trans-fats (hydrogenated oils). However, it did mention the deleterious "cafeteria diet" of Doritos, oreos, and Fruit Loops, which is built on trans-fats. Trans-fats is a prime suspect since the body doesn't process it the same way as regular fats.

It almost seems like the author wanted to emphasize a sense of mystery above factual reporting?
posted by dum spiro spero at 1:07 PM on July 11, 2021 [10 favorites]

We absolutely do talk about the "tobacco epidemic". The WHO says: (blah blah blah)

EXACTLY! Thank you for proving my point. The focus is on the tobacco, not the human beings who ingest it. It's not a "smoker's epidemic", but a tobacco epidemic. We can have a war on tobacco use, then, but the war on fat is often a war on fat PEOPLE.
posted by Flock of Cynthiabirds at 1:10 PM on July 11, 2021 [23 favorites]

100kb, here's the only lab rat CO2 study I've found; it's focused on the respiratory effects of CO2 rather than obesity. And given the results, I can see why people are reluctant to do these experiments:

Mouse Lung Structure and Function after Long-Term Exposure to an Atmospheric Carbon Dioxide Level Predicted by Climate Change Modeling

The changes we've made to our atmosphere have been sufficient to raise the temperature of the entire globe more than a degree, and cause devastating weather effects. I'm puzzled as to why people think that, as large mammals with disproportionately big brains, we're just going to be able to keep breathing whatever and it'll be fine.

Childhood obesity linked to air pollution from vehicles
posted by MrVisible at 1:13 PM on July 11, 2021 [11 favorites]

There's really no question to me that something has happened since the early 1970s. As a lifelong Very Large Man (6'4"+, 300lbs+) born in the early '70s, I've been "off the chart" in terms of height and weight since I was just a few years old. This is very likely uniquely genetic; my Mom tells me that I recognizably have the very same dimensions and unique body shape as a Very Large Uncle (born in the depression!) of hers, and my biological brother shares a nearly identical height, weight and body shape despite the two of us having lived radically different lives and despite having different philosophies towards cooking and eating. There were Very Large Men of every era, and I think it's reasonably possible that, unless I grew up during a time of extreme famine, I simply would have ended up the way that I am.

But when I was a young man, I was alone. Almost nobody I met for years and years of my life, even during travels, were as tall or big as I was; I was larger either by height or weight than literally anyone in my community, even as a teen. That's no longer the case. For years now, I've regularly come across people taller or larger than me day to day. I sometimes look at pictures or home movies from my childhood, and I'm just astounded - compared with the way things are now, I don't really look abnormally large, even it's documented that at the time (and in photos amongst my classmates) I certainly was. But on a recent post-COVID trip to a common tourist attraction, and many others in the past decade, there's just no question that there are any number of tall men and even larger folks.

Something is going on, and it's true, we really don't know what it is.
posted by I EAT TAPAS at 1:16 PM on July 11, 2021 [10 favorites]

While I am certain that air pollution has many bad effects, in my country, people are a lot slimmer in the cities, where air pollution is concentrated, than in the countryside. My impression is that this is the same all over the world, but I don't have the statistics to prove it.
posted by mumimor at 1:19 PM on July 11, 2021 [1 favorite]

I did eventually read much of the article, and yes it is far less offensive than the post. The title of this post should be killed with fire because it implies heavily that fat people are fat because they eat so much har har hurf durf.

I feel like the article doesn't take enough time to explore why there is less obesity in older and more traditional societies. It seems to sweep aside the idea of greater exercise levels having anything to do with it. I would imagine there are many other differences--such as gut microbiome, stress levels, exposure to plastics, amount of sleep, and exposure to sunlight. I wonder if vitamin D levels have anything to do with it; many people in the modern "developed" world stay indoors most of the time and slather themselves with sunscreen when they go out. I have trouble keeping up my vitamin D levels even while taking supposedly sufficient supplements. And I've read that low vitamin D is correlated with obesity.
posted by Flock of Cynthiabirds at 1:20 PM on July 11, 2021 [3 favorites]

People are always making facile comments about the US being the fattest country, but according to this, the top ten fattest countries are small Pacific island nations. #11 is Kuwait. The US is #12, but there are several Middle Eastern countries right behind. The countries dominating the bottom of the list are Asian and African. I don't know what it all means but it's interesting.
posted by LindsayIrene at 1:24 PM on July 11, 2021 [1 favorite]

People are always making facile comments about the US being the fattest country, but according to this, the top ten fattest countries are small Pacific island nations. #11 is Kuwait. The US is #12, but there are several Middle Eastern countries right behind. The countries dominating the bottom of the list are Asian and African. I don't know what it all means but it's interesting.

The common denominator is highly processed food.
posted by mumimor at 1:31 PM on July 11, 2021 [4 favorites]

The author seems to dismiss diet and exercise as factors within the first few paragraphs. Yeah, it is weird that obesity is on the rise—I mean, it’s weird if you ignore changes in diet and exercise. Bizarre kind of reasoning here.
posted by Don.Kinsayder at 1:36 PM on July 11, 2021 [5 favorites]

I'm fat. I'm also super active, or at least I was before pandemic isolation (which is still ongoing here), biking and walking everywhere. I wish I was less fat so I could dance more, climb trees and walk further without my knees hurting.

I'm one of those kids that were born with normal weight, but had voracious apetite from early in life. I suspect it has to do with stress. My mother is a raw nerve of untreated PTSD from her childhood in the eastern front of WW2, and I got it second hand via nurturing and maybe epigenetics. I've been in therapy for my whole adult life: consueling, freudian, jungian, lacanian, CBT, also meditation, exercise, martial arts, legal drugs, illegal drugs, you name it. All of this has helped, but I'm still always hungry. And when I eat I calm down.

My guess is that stress from capitalism is a factor in this. Being unsure about the future. Obesity has exploded in the 80s, that's when Reagan and Thatcher and neoliberalism happened. There's a link between poverty and obesity, it's interesting that the article didn't mention it.

Maybe the animals in lab cages can sense stress from the researchers? Low level, like background radiation. That would be an interesting experiment.

All I know is that this way of life of ous is deeply fucked up – the last 10 years have made this clear. It's not too far fetched to imagine that our lizard brains respond to uncertainty by hoarding calories.

posted by Tom-B at 1:38 PM on July 11, 2021 [29 favorites]

And yeah, I think that the article is OK, but the post title is offensive. The first sentence would make for a better title: The obesity epidemic is deeply weird.
posted by Tom-B at 1:55 PM on July 11, 2021 [1 favorite]

Forget the obesity crisis; we have here an ignorance crisis. The number of people commenting here without having read the article is really unhelpful. This topic is important and the two linked articles here are well researched summaries of where we stand today. Give it and the community here some respect.

The author seems to dismiss diet and exercise as factors within the first few paragraphs

You might want to read the rest of the two articles, which go into great detail about dietary changes and how none of them explain the phenomena we're seeing.

ctrl-F endocrine disrupt

You might want to read the article instead of just snarkily talking about your browser's text search function. Also if you have something to contribute to the discussion maybe do that? Instead of typing two words without context?

I did eventually read much of the article

Hey, great!
posted by Nelson at 2:07 PM on July 11, 2021 [67 favorites]

Okay, I read both installments of the blog, and remain unconvinced. The author devotes one paragraph to diet+exercise, and does so in order to dismiss the effect of diet+exercise on weight based on a summation of one meta-analysis. Not convincing.
posted by Don.Kinsayder at 2:28 PM on July 11, 2021 [2 favorites]

Trans-fats is a prime suspect since the body doesn't process it the same way as regular fats.

I believe this issue is multifaceted but if it is of significant contribution then Canada, which banned trans fats in 2020, should see the effects.
posted by Mitheral at 2:33 PM on July 11, 2021 [3 favorites]

Sorry, two meta-analyses. The author points to one, and then vaguely gestures to others. One is pointed out, others are mentioned, but only two are quoted and linked.
posted by Don.Kinsayder at 2:34 PM on July 11, 2021

Most of the second part of the piece is about diet and exercise.
posted by Spathe Cadet at 2:39 PM on July 11, 2021 [4 favorites]

Have you heard? If we chant "Diet+exercise" hard enough, maybe this time the one true study that fits my preconceived expectations will emerge.
There isn’t even one peer-reviewed controlled clinical study of any intentional weight-loss diet that proves that people can be successful at long-term significant weight loss. No commercial program, clinical program, or research model has been able to demonstrate significant long-term weight loss for more than a small fraction of the participants. Given the potential dangers of weight cycling and repeated failure, it is unscientific and unethical to support the continued use of dieting as an intervention for obesity.
posted by CrystalDave at 2:39 PM on July 11, 2021 [32 favorites]

A lot more than one paragraph is dedicated to diet and exercise. In fact, many paragraphs are dedicated to different approaches to diet and exercise.

I find the overeating studies very compelling. Apparently, one can overeat intentionally and cause a short term worthy gain, but then lose it very easily by reverting to the previous diet. And yet careful dieting for years helps barely if at all for millions of people. This seems like an excellent indicator of a disrupted regulatory system: You can easily temporarily knock the system to a different operating point, but as soon as the treatment is removed, the system will quickly self-regulate back to its default value, wherever that may be.
posted by kaibutsu at 2:43 PM on July 11, 2021 [11 favorites]

I like that article for its commitment to expressing the weirdness of things.

For me, my current belief is that we don't know. Everyone has a Theory and an Idea and so many of those are put forward in this thread. But science has not come to any useable consensus yet.

And people are so bad at living in that space! We give weight moral values, we treat it like a plague, we insist on our One True View about it...and in the process we hurt people. A lot. A lot. Especially doctors who won't help people who are overweight because of their biases.

Anyways, my crackpot theory to contribute to this is that fossil evidence shows that in some areas of the world mammals used to be a lot bigger! Maybe we are just returning to standard.
posted by warriorqueen at 2:48 PM on July 11, 2021 [14 favorites]

I'm very interested in there being a sudden shift from men gradually losing weight with age (and stable before that, I guess) to men suddenly getting fat(ter?) between age 30 and 40. This can't be diet culture, they weren't dieting.

It's got to be a metabolic change, whether biome, pollution, or infection. That last is surprising, but there's an adenovirus which makes chickens fatter on the same diet. That particular virus seems to be slightly involves in fat storage for humans, but not nearly as much as for chickens. Still, we have proof that it *might* be a virus.
posted by Nancy Lebovitz at 2:51 PM on July 11, 2021

There's a book called _Diabetes Rising_ which points out that both kinds of diabetes were rare diseases a century ago, and no one has a solid theory about why they've become common.
posted by Nancy Lebovitz at 2:52 PM on July 11, 2021 [2 favorites]

Yes, likely multiple things in play; many synthetics (esp. herbicides, plastic softeners(endochrine mymics), lifesyle('choices' forced by capitalism), and yes very likely CO2(as we -and all our food- developed when CO2 was 280ppm). Funny how author doesn't look at herbicides.

Roundup / glyphosate (sold since 1973) is one of the most ubiquitous synthetic molecules, commonly found in human urine, earthworms and soil fungi (where it alters hydrology and worm health), freshwater mussels (changes to reproductive systems).

I have 22 glyphosate papers/theses on my drive, some from non-chemists, mainly AFAICT as most universities receive huge $ from agrichem "come and see the Bayer wing of science..". One of the most intesting is Samsel and Seneff's Glyphosate’s Suppression of Cytochrome P450 Enzymes and Amino Acid Biosynthesis by the Gut Microbiome: Pathways to Modern Diseases - P450 occurs in many living systems, changing its function should be expected to have cascading effects. I've been told by wastewater plant operators that AMPA causes system malfunction.

I went to an agriculture (arable farming) conference two years ago by the professor of Toxicology from U Canterbury (NZ), he put up a slide that showed the molecular similarities between glyphosate and some human enzymes. Funny thing was that the words were all very safe, he just put up some slides and said no comment, and then carried on.

Disclosure - I do things that result in a lot of herbicide being used (economics of anything involving plants is predicated on herbicides being available) - it's like having a dozen free staff. But having studied and worked with them I know what they do in living systems so continually trying to avoid use.
posted by unearthed at 2:54 PM on July 11, 2021 [21 favorites]

CrystalDave, your declaration “there isn’t even one” links to a single paper that makes the rather modest claim that medical interventions should be personalized and directed towards a patient’s realization of a healthy lifestyle. So, in sum, you haven’t really bested me or whatever, and, to that point, it’s awfully weird that you’re coming at me for expressing some rather mild skepticism over blog posts made by some anonymous bloggers.
posted by Don.Kinsayder at 2:58 PM on July 11, 2021 [2 favorites]

The style of writing in these posts has the feverish quality of quackery. That’s all. I’m suspicious of someone who wants to sell me something by continually telling me that weirdness is afoot. All is weird—deeply weird!
posted by Don.Kinsayder at 3:03 PM on July 11, 2021 [5 favorites]

There doesn't seem to be one cause and one silver-bullet fix.

Overlooked in those links: Height has gone up, and if everyone was the same density you'd grow in weight proprtional to the the cube of the height; but we also have to have thicker bones and bigger muscles (which are more materially dense than average human biomass). So a more tall people mean disproprtionately heavier tall people.
posted by k3ninho at 3:08 PM on July 11, 2021 [3 favorites]

To start with, unless a key, but invisible event took place in 1976, it is highly unlikely that BMIs all started rapidly increasing, just like that, all of a sudden.

Roundup, the herbicide, was first brought to market in 1976.
posted by mhoye at 3:22 PM on July 11, 2021 [37 favorites]

Have you heard? If we chant "Diet+exercise" hard enough, maybe this time the one true study that fits my preconceived expectations will emerge.
CrystalDave: that has to be read including the “Any intervention strategy for the obese should be one that would promote the development of a healthy lifestyle.” part. It’s true that tradition interventions don’t work but that’s because it’s hard for most people to sustain a net caloric deficit without looking at the larger lifestyle factors. Most of the 20th century was spent pushing people into very sedentary lifestyles surrounded by cheap unhealthy food (not to mention how often food has been turned into a status symbol or emotional outlet), so it’s unsurprising that anything which doesn’t try to change the larger system is about as successful as telling brown people that it’s their individual responsibility to deal with racism by going to Stanford.

The key part, though, is remembering that diet & exercise improvements work reliably for almost anyone who can change their lifestyle so their default is healthy. We should be talking about how to do things like get people out of car commutes, improve the quality of food available in many contexts, make safe options for outside physical activity (especially replacing car usage) available in all neighborhoods, removing subsidies for unhealthy foods, etc. – not saying that screws don’t work after tossing a few of them at the wall and being surprised that they fell out.
posted by adamsc at 3:29 PM on July 11, 2021 [12 favorites]

Gina Kolata's Rethinking Thin suggests that people might be getting taller, fatter, and healthier.
posted by Nancy Lebovitz at 3:29 PM on July 11, 2021 [6 favorites]

Posts about diets, obesity, weight loss, etc. on MetaFilter should come with a special houserule that no one can post a comment until they prove that they've actually read everything in the post and any comments above theirs.

BRB, gonna call the ReCaptcha people to whip up something.
posted by The Pluto Gangsta at 3:37 PM on July 11, 2021 [20 favorites]

I stop reading at the first sign of idiocy. It was here: ”Sources have a surprisingly hard time agreeing on just how much more we eat than our grandparents did, but all of them agree that it’s not much. Pew says calorie intake in the US increased from 2,025 calories per day in 1970 to about 2,481 calories per day in 2010. The USDA Economic Research Service estimates that calorie intake in the US increased from 2,016 calories per day in 1970 to about 2,390 calories per day in 2014. Neither of these are jaw-dropping increases."

With the standard 3500 calories/pound rule of thumb, that calorie increase implies a weight gain of roughly 300 pounds a decade.
posted by Mr.Know-it-some at 3:38 PM on July 11, 2021 [25 favorites]

You might want to read the article instead of just snarkily talking about your browser's text search function.

And you might want to do me the courtesy of not assuming that I hadn't.

As a lifelong fat man who, thirty years ago, dropped 60kg and experienced being lean for maybe four years, and would prefer to get and remain lean again were it not for the relentless grinding misery required to reach and maintain that state via disciplined starvation and exercise, this is a subject of considerable interest to me.

Mention of endocrine disruptors is a notable omission for an article that opens with
Current theories of the obesity epidemic are inadequate. None of them hold up to closer scrutiny...
and goes on to explain in some detail about why not. I thought it was an omission worth drawing attention to. I should not have to explain that to you like you were five.
posted by flabdablet at 3:38 PM on July 11, 2021 [11 favorites]

Height has gone up, and if everyone was the same density you'd grow in weight proprtional to the the cube of the height; but we also have to have thicker bones and bigger muscles (which are more materially dense than average human biomass).

BMI accounts for height. And before anyone starts talking about body fat percentage let's be real, the vast majority of people labeled "overweight" or higher are not overflowing with muscle and hitting the weights daily. It generally takes serious training to reach that point. If we want to talk body fat percentage then if anything BMI underestimates the number of people with excess body fat--the comparatively inactive lifestyle of people in "developed" countries results in plenty of people with normal BMIs who have a body fat:muscle ratio that's inadvisable.
posted by Anonymous at 4:08 PM on July 11, 2021

There are questions about the usefulness of the BMI, especially for people who are six feet or taller, or five feet and under in height. It was, after all, devised in the 1830s. Here are a mathematician's thoughts.
posted by LindsayIrene at 4:21 PM on July 11, 2021 [6 favorites]

In light of flabdablet's observation of no mention of endocrine disruptors and mine re herbicide being omitted ... how sure are we that slimemold are not part of a disinformation op? I'm on wordpress too, and most people are not very anonymous, why is this person?

Their unspecified 'Research' is doing a lot of work; If I ever publish something I'll shout it from the rooftops.
posted by unearthed at 4:47 PM on July 11, 2021 [1 favorite]

With the standard 3500 calories/pound rule of thumb

I wish people here wouldn't post roundly debunked bad science. The whole point of the linked articles is talking about how weight loss is a lot more complicated than simplistic falsehoods.

The "3500 calorie rule" comes from the observation in 1958 that a pound of body fat contains about 3500 calories of stored energy (a paper in turn based on some 1911 measurements). Ie: if you take out a pound of fat from a body and burn it in a calorimeter, it produces 3500 calories. A neat, if grisly fact. Also not very useful information for people trying to lose weight. From that simplistic analysis a bunch of geniuses concluded "well clearly if you eat 3500 calories of food, that will create one pound of fat! Just eat 3500 calories fewer and, why, the pounds will melt right off." (Generally stated with various levels of insulting derision.)

Unfortunately this is just really not true, and it's so not true you're hard-pressed to find any modern citation even repeating the myth. Some of the details of this problem are summarized in the second linked article under the section titled "2.1 Calories In, Calories Out".

I stop reading

Really not helping the conversation about the article we are reading.
posted by Nelson at 5:04 PM on July 11, 2021 [34 favorites]

Roundup, the herbicide, was first brought to market in 1976.

HFCS usage began at industrial scale in the mid-70s. Altering diets on that scale may have had knock-on effects on population gut biomes, potentially affecting even those with lower consumption rates. There are some studies in the late 2010s on mice gut flora changes on a high HFCS diet, with downstream metabolic pathologies.
posted by They sucked his brains out! at 5:10 PM on July 11, 2021 [6 favorites]

Hard to say, really. Like the chemical body burden, lots of circumstantial and indirect evidence, but nothing directly causal that can implicate any part of food production and agrochemical industries. Which is useful in its own way, I guess.
posted by They sucked his brains out! at 5:13 PM on July 11, 2021

The 3500 calories/lb rule isn’t really the key part of the argument. It seems to me that if the information that people eat 15% or 20% more calories in the 2010s than in 1970 is reliable, we don’t exactly have the stone cold whodunnit that the article says we do.
posted by chrchr at 5:17 PM on July 11, 2021 [11 favorites]

It’s telling that it is believed caloric intake was even higher earlier in the century. Our bodies are good at guiding us to eat what we need when functioning properly. The evidence makes a pretty compelling case that there is some external change which has occurred. I’ve long been suspicious of fire retardants, but the links I’m finding about glyphosate (round-up) today are pretty compelling and damning. Viral epigenetics is also a possible theory.
The more we can talk about these topics without devolving to moral theories of “personal responsibility”, the better from my point of view. It’s no more helpful here than at any of our other global issues.
posted by meinvt at 5:24 PM on July 11, 2021 [8 favorites]

The first part ends with a link to the second part ("[Next Time: CURRENT THEORIES ARE INADEQUATE]"]; the second part ends in the same way ("[Next Time: A CHEMICAL HUNGER]"]) but is presently without a working link, implying that there will be at least a third post. Also, the final paragraph of the second part
We should start seriously considering other paradigms. If diet and exercise are out as explanations for the epidemic, what could possibly explain it? And what could possibly explain all of the other bizarre trends that we have observed?
looks like it's plausibly setting up environmental factors as the topic of the next part, and is not meant as the final installment of the series.

Does MeFi not do good faith readings of anything anymore? (Did it ever? Could it, at some point in the future?)
posted by Spathe Cadet at 5:33 PM on July 11, 2021 [17 favorites]

If you read the “about” section of the blog, you’ll see these authors are trying to sell their services as consultants and are angling for a book deal. I think they want to be Freakonomics 2.0.

No, I don’t owe them a thing.
posted by Don.Kinsayder at 5:37 PM on July 11, 2021 [3 favorites]

Mod note: Folks, let's keep things on-topic and refrain from making things personal/getting into it with other users.
posted by travelingthyme (staff) at 5:47 PM on July 11, 2021 [3 favorites]

To start with, unless a key, but invisible event took place in 1976, it is highly unlikely that BMIs all started rapidly increasing, just like that, all of a sudden.

Just spitballing here, but 1976 would be just about when HFCS started being used in place of traditional sweeteners in many food products. IIRC, the production of HFCS really took off following the big deregulatory changes in 1973 (thank you Earl Butz), which resulted in an overproduction of corn, making HFCS cheaper than cane or beet-derived sweetener.

The agribusiness industry has been saying for years that HFCS is just as good/bad as other sweetener, but... perhaps they have a vested interest in telling us that.
posted by Kadin2048 at 5:54 PM on July 11, 2021 [3 favorites]

I'd be surprised if any new chemical introduced in 1976 would have a big effect right then. I'd expect some lag.
posted by Nancy Lebovitz at 5:58 PM on July 11, 2021 [4 favorites]

HFCS usage began at industrial scale in the mid-70s.

Never really took off in Australia - we still grow more sugar cane than maize here - and the obesity epidemic is here as well. Sucrose pretty swiftly breaks down into glucose and fructose anyway. I'd be surprised to learn that HFCS has metabolic effects notably different from those of sucrose, so I'd expect the remarks in the article's "Sugar" section to cover it.
posted by flabdablet at 6:14 PM on July 11, 2021 [8 favorites]

looks like it's plausibly setting up environmental factors as the topic of the next part

Would certainly hope so.
posted by flabdablet at 6:16 PM on July 11, 2021

Regardless of tone arguments, the citations in the post 1) exist 2) go to reputable sources and 3) generally seem to say what they're claimed to say, which is a lot further than almost any quack or bullshit artists gets, so I think the level of skepticism here is quite unwarranted.

Honestly, the argument that struck me most, and that I hadn't known before, is that people in the US on average seem to have taken doctors' advice on exercising more and eating less refined sugar over the last decade or two... and it has not slowed the increase in obesity one bit!

It seems like that's pretty nearly the final nail in the coffin for the theory that population level diet and exercise changes are the main driver of obesity. Public health campaigns clearly changed behaviors. They did not change the outcome. That's pretty conclusive.
posted by Zalzidrax at 6:20 PM on July 11, 2021 [24 favorites]

Previously a study demonstrates that eating ultra-processed foods induces people to eat more than if they eat unprocessed foods.
posted by chrchr at 6:48 PM on July 11, 2021 [6 favorites]

So I can eat processed crap or raw stuff that is probably contaminated with glysophates. And who even knows what's in the water!

Fucking awesome
posted by emjaybee at 7:11 PM on July 11, 2021 [3 favorites]

I was underweight most of my childhood, and always in the "normal" BMI range as an adult, no matter what I ate. There was a whole semester in college where I ate basically nothing but fast food because my housemates made using the kitchen impossible. I was also using a power wheelchair at the time and getting essentially no exercise. Stayed the exact same weight as I was when eating healthy home-cooked meals over the summer, or eating semi-decently (read: had vegetables at least twice a week) at the cafeteria when I had a meal plan.

Fast forward five years of rock-steady weight. Over the course of the pandemic I started eating out less and cooking more at home, eating more veggies, drinking more water, etc. I admit my exercise slipped but it was better than when I was in a wheelchair in college. I gained 20 pounds. ¯\_(ツ)_/¯

Anyone talking about the role of stress in weight gain? Because that's something else that's definitely increased over the years. And I'm not convinced that all the "pandemic weight gain" is due to people moving around less and eating worse--a lot of people have been eating better and exercising more now that they have the extra time. And yet.
posted by brook horse at 7:22 PM on July 11, 2021 [28 favorites]

my evo-psych theory: sitting is more destructive than it's credited. early h. sapiens didn't sit much. sitting signals the brain that there's illness or injury, turning up the lipo-stat to be sure calories are banked for healing.

(i think evo-psych is basically astrology)
posted by j_curiouser at 7:48 PM on July 11, 2021 [3 favorites]

I went to an agriculture (arable farming) conference two years ago by the professor of Toxicology from U Canterbury (NZ), he put up a slide that showed the molecular similarities between glyphosate and some human enzymes.

This is a physical impossibility. Enzymes are proteins that weigh 10,000 to 1,000,000+ atomic mass units. Glyphosate is a small molecule that weighs 170 atomic mass units. It's like saying "here is a one inch screw and and here is a 18-wheeler truck - they are similar".

Perhaps you mean "similar shape of glyphosate to the active site in enzymes?".
posted by lalochezia at 7:52 PM on July 11, 2021 [8 favorites]

lalochezia, yep, similar shape, guy was racing through it, I just got some screenshots and verbal tidbits, also I'm not a chemist; I'm just a fancy gardener with a couple of degrees, so, yeah most of it was whoosh over my head.
posted by unearthed at 8:30 PM on July 11, 2021 [2 favorites]

"In short, when food supplies are low, everyone stays hungry, and no one gets fat. But when food is plentiful, some people get fat and others don’t. Whether they do or not is largely determined by their genetics. The real reason for the obesity ‘epidemic’ is that we have almost banished hunger in many of the world’s nations. We are seeing what a human population looks like when everyone has enough to eat."

posted by Barbara Spitzer at 8:42 PM on July 11, 2021 [7 favorites]

jesus, i guess that was a thing you just linked.

missing from that screed: why are the lab animals getting fat? the entire point of a lab animal is that it responds identically to identical conditions. give it the same amount of food, it maintains the same weight. why, given that the animals are getting the same amount of food, why are they getting fatter?

are the lab animals more prosperous now?
posted by logicpunk at 9:26 PM on July 11, 2021 [7 favorites]

I bet the slide was showing the structural similarity between glyphosate and the amino acid glycine. (Glyphosate is glycine, plus a phosphonomethyl group on the nitrogen.)
posted by Spathe Cadet at 10:20 PM on July 11, 2021 [3 favorites]

If the global change in obesity levels is, as the articles seem to imply, primarily driven by something affecting our internal fat-regulation systems, it must be awfully subtle. They present decent arguments that such a system must exist, but IIUC we haven't identified one even though the ability to target people's desired weight would be a bonanza for pharmacological companies.

Assuming such a system exists, how is it targeted? Their arguments against weight being driven by diet imply that it isn't affected primarily by diet; it can't be global pollution levels, because populations in different places react differently. And how do we explain the obese lab animals?

I think that if this is real, it's a confluence of causes, or something that potentiates a cause. E.g., if it's a microbiome thing, it's the microbiome plus a particular diet. Or, because there are/were non-obese cultures with high fat / high sugar / whatever diets: it's one of several microbiomes and diets respective to them. It might even be that as a globalised population, we're the recipients of multiple microbiomes that were historically optimised for particular diets, but now we have flora evolved for high-fat diets interacting with flora evolved for high-sugar diets and flora evolved for high-protein diets, and that's why whatever we eat is wrong. Whatever we eat, part of our microbiome sends out a "LAY FAT DOWN NOW PLZ" signal.

Anyway, they're good articles and I look forward to reading the conclusion.
posted by Joe in Australia at 10:44 PM on July 11, 2021 [1 favorite]

I see people here worried about the credentials and motivations of the authors. It's worth noting that the articles seem to take most of their information from Stephen Guyenet's The Hungry Brain (that's how I became familiar with a lot of this stuff), so you can just skip the middleman and defer to that if you'd prefer. Guyenet's website has a lot of extra resources on the subject to explore.
posted by painquale at 12:06 AM on July 12, 2021 [10 favorites]

Back to the lab animals, unless they're violating the second law of thermodynamics they can't be taking in the same amount of food and getting fatter. If there's no genetic changes, no environmental changes and they're getting the same amount of calories it is really concerning.

That would only be the case if the previously regular sized lab animals were 100 percent efficient at processing their food. I'm pretty sure they were not. They could have just pooped out more in the past, and now they are turning it into fat. No thermodynamics being violated.
posted by Iax at 1:43 AM on July 12, 2021 [12 favorites]

Minor point: Froot Loops [sic] and salami

Froot Loops shouldn't be [sic] and comes off as condescending. Froot Loops is correct, it is a brand name.
posted by geoff. at 1:45 AM on July 12, 2021 [8 favorites]

Mod note: A few deleted. Yeah, not the second law of thermodynamics thing. Don't be that guy; it's beyond tired. Also, what cortex said. Also, what thyme said. Also "it's a joke" will not fly here, and you are skating on very thin ice for a site ban with that kind of crap.
posted by taz (staff) at 2:43 AM on July 12, 2021 [2 favorites]

I’m of pretty average weight, with a tendency to add pounds in the fall and winter, lose some in the spring and summer. Peasant genes.

When I was grieving my daughter and pregnant with my now-son, I couldn’t gain weight. The ultrasounds showed a small baby and my obstetrician was worried. I had nutrition counseling and had to track everything I ate and all my exercise. Eventually I was eating *4500* calories a day, which should have fulfilled a fantasy but did not, it was gross. I would start crying at 4pm trying to get the remaining calories in. I drank whole milk mixed with protein powder, and ice cream, and tapioca, and sometimes fast food.

There was never an explanation. My thyroid was pretty normal throughout.

I gained 12 lbs, compared to 23 in my first to-term pregnancy. (23 is closer to standard.)

baby was fine, but smallish - 5lb6oz. He is now quite huge for his age, big shoulders, size 13 shoe at 15 yrs.

As for my body, I dropped 22 lbs in the first three weeks after giving birth (breastfeeding is crazy), even though I had now kind of adjusted to eating a lot. After a year of continuing to have to watch my weight in the sense of eating enough, I started a slow gain for 3 years. Hit a high, recalibrated, ended up about where I am now (I’m up about 3 lb from usual due to pandemic but it’s coming down.) food is weird.


A few years ago a friend of mine, who was obese, hurt her back around when I had a disk collapse. I got imaging, an explanation (I’ve broken my back, it’s 20 yrs older than I am in medical slang), and drugs. My doctor explained that until the pinched dying nerve died, I would be in pain and please please take my meds.

My friend got lectured and nutrition “counseling” and a 1,000 calorie a day diet. She was almost suicidal from sleep deprivation and pain, plus her weight went up despite her efforts. Finally she got imaging. Same problem! EVEN THEN she had to fight to get painkillers. It was awful. She couldn’t get help.

This is what we are doing to people when we focus on calories. It’s lazy. It doesn’t help them.

Also, neither of us has gotten an explanation for our weights vs. our intakes. But with me, because mine was not making me overweight, I got kind thoughtful help (that still didn’t really help.) She got shame and judgment.
posted by warriorqueen at 3:09 AM on July 12, 2021 [58 favorites]

I haven't read all the comments here yet, but as for the lab animals, isn't it possible their food too has been worsening in the name of profit? I mean, it's not like these animals are treated kindly, allowed exercise or socialization or even relief from often sustained and lifelong pain, stress and torment. They are not treated like sentient beings. If their food could be procured for cheaper, or made cheaper, does anyone doubt that this would happen? (I won't even start in on animals grown for food. Sentient. Creatures. All of them.)

And just one more note. Restrictive diets never work because changes to diet must be sustainable and restrictive diets are never sustainable over the long term. Plus they can screw badly with metabolism and mental and emotional well-being. One of the major problems with western medicine (with some very, very minor recent changes), is that most doctors get zero nutrition training. Zero. There is much more profit in medication and expensive procedures.

Lifestyle medicine is a slowly growing field and I believe this is where the answer lies. But Big Pharma and Big Ag and Big Dairy, they still have enormous money and power and they will not be going anywhere without a lot of fighting and misinformation on top of their astonishing lack of ethics.
posted by Glinn at 6:19 AM on July 12, 2021 [5 favorites]

It's worth noting that the articles seem to take most of their information from Stephen Guyenet's The Hungry Brain

Stephen's Guyenet Explains His Disagreement with Gary Taubes | JRE Obesity Debate

cued to the second part of a lengthy preamble. And yes, a WARNING: JRE = Joe Rogan Experience.
posted by philip-random at 6:40 AM on July 12, 2021

Portions going up is not just in restaurants and with processed food. Modern dinnerware is substantially larger than vintage stuff. Our cottage was kitted out 70 years ago with all the old stuff my grandparents didn't want anymore, and at home we have a bunch of 1930's and 40's kitchenware my great-aunt gave us. Plates are much smaller, cups are smaller, coffee cups are tiny compared to modern mugs, bowls are maybe half the size. I'm 50, and there have been changes in expectations on portion size since I was a kid. When I was young, fruit juice was always served in tiny "juice glasses", probably enough to hold the juice of one or two oranges. If you have a cup of coffee in a vintage coffee cup, you are drinking half as much coffee, so if you use cream and sugar, half as much of that. I've read various on-line claims that plate sizes have increased 25 to 35% since the 1960's.

Cookie size is another example . . . old cook books have recipes that make cookies that are at most 2" in size, while a lot of cookies you see now are the size of a beer coaster.

I find I gain when I eat processed foods, over-indulge on beer (usually in the summer), and use the new dishes. I lose when I avoid processed foods, cut back on the beer, and make a point of using vintage dishes. They don't hold as much food, so I naturally eat less without even thinking about it.

My most recent portion annoyance is how hard it has become to find a lot of beer in non-tall cans now. Sometimes it is nice to have just a glass of beer with a meal, I don't want a whole pint. My wife and I can just share a tall can, but right there is a big increase in portion size if you don't.
posted by fimbulvetr at 6:57 AM on July 12, 2021 [14 favorites]

I don't know why obesity is rising so drastically and I don't think anyone else really does, but it seems like the author here has a conclusion they want to get to and aren't going to let facts get in the way.

When they conclude that "People in 1950 were a lot leaner than they are now, but it’s not because they ate less and exercised more" it seems like they are really stretching to dismiss caloric intake and exercise as factors. Even the data that they present shows people ate about 15-20% less in 1970! And their discussion of exercise seems to show that it does help people lose weight, though perhaps not as much as people would like. The idea that people in 1950 ate less and walked or physically worked more and thus were leaner doesn't seem that farfetched to me and certainly isn't contradicted by what they have presented here. These might not be the only factors or even the most important ones, but it sure does suggest the author has an agenda that isn't entirely driven by the evidence.

Surely this data would lead us to ask why we are eating more?

Finally, I wonder about the distribution of caloric intake. I wouldn't be surprised to learn that there is more spread in daily caloric consumption now than there was 50 years ago. There could easily be a quarter of the population or something that consume a lot more calories, which may not have been the case 50 years ago.
posted by ssg at 8:35 AM on July 12, 2021 [14 favorites]

Cookie size is another example . . . old cook books have recipes that make cookies that are at most 2" in size, while a lot of cookies you see now are the size of a beer coaster.

My oven is from the 1970s and it is so small, we have to buy specialty bakeware to fit inside. Since the 1970s the average density that people live at has also fallen, which also started to shift in the 1970s from primarily central cities to suburbs. This implies that people used to walk more and get more general exercise.

isn't it possible [that lab animal] food too has been worsening in the name of profit?
Yes of course, and it's also possible that their diets aren't particularly strictly controlled across the entire population.

Food has also gotten generally cheaper due to industrial processing. I probably post this a lot, but a McDonalds tiny hamburger cost the equivalent of $1.50 in the 1950s and only costs about $1 now. Soda has a very similar cost curve. Imagine if food had been on the same cycle and cost 1.5X as much.
posted by The_Vegetables at 8:41 AM on July 12, 2021 [5 favorites]

I believe that it is totally possible and probable that there is a hormone or chemical disruption owing to the environment, and that it is true that we eat more because:

Food used to be more expensive and not as good as it is today. We all laugh at American cookbooks from the old days, with recipes that are either dull or bizarre. That was what you got, unless you belonged to an ethnic minority with a good menu or lived near their restaurants.

It used to be slightly more difficult to buy and store food. The concept of the 24/7 store is relatively new, and it doesn't happen overseas as much. Refrigerators and freezers were much smaller.

Dishes and glasses were smaller, as fimbulvetr says. Compare a martini glass from the '30s to today's. Not that people didn't drink too much back then, because it's unbelievable, but still.

Lack of widespread availability of highly palatable processed snacks.

I don't think that means we're bad people for eating more or enjoying it more. I also am not going to conclude that all this is Our Fault.
posted by Countess Elena at 8:48 AM on July 12, 2021 [5 favorites]

I did not see one mention of changing transportation habits (i.e. cars), which surprised me. That has always been my go-to explanation of why people in cities where public transit is a thing are slimmer than people outside them, and the timeline roughly fits the rise in obesity.

The article mentions that there are some hunter-gatherer societies that have similar amounts of physical activity to Americans, but really? I can't follow the reference, but it seems unlikely if they're not driving.

Do Pacific islands have lots of cars for their populations?
posted by alexei at 9:42 AM on July 12, 2021 [6 favorites]

The linked blog posts are interesting and link to solid evidence, but are also an exercise in a kind of reverse pareidolia, in that the authors are way too quick to dismiss patterns on the basis of suspect readings of individual studies. Let's have a look at the second piece of evidence that they cite. Here's the context in which it is cited:

People in the 1800s did have diets that were very different from ours. But by conventional wisdom, their diets were worse, not better. They ate more bread and almost four times more butter than we do today. They also consumed more cream, milk, and lard. This seems closely related to observations like the French Paradox — the French eat a lot of fatty cheese and butter, so why aren’t they fatter and sicker?

To support that tidbit of information about bread and butter, they cite a 2010 article titled "Trends in food availability, 1909–2007." If you RTFA it paints a much more complicated picture:

(1) The cited article starts at 1909, not "the 1800s." That's a stretch.

(2) The article itself is about food availability (it's right there in the title!), not food consumption. In the introduction, the article author notes that "Food availability data do not, however, typically account for losses through spoilage, plate waste, food preparation practices,or other factors. As a result, they overestimate consumption." They also note that the way the USDA estimates food availability has changed over time, and loss-adjusted estimates only started after 1970, so the earlier estimates probably overestimate consumption even more. It is reasonable to assume that losses from spoilage, food preparation, and other factors have also changed over time. So availability is a proxy for consumption, but is not a direct measure of consumption, and there are serious problems with comparing between different eras. Yet the blog authors state without equivocation that "their diets were worse." That's a big stretch.

(2) If you look at Table 1 in the article you will see that availability of bread, butter, cream, milk, and lard was indeed higher in 1909. You will also see that availability of the following foods was lower: meat, fish & shellfish, cheese, frozen dairy products, margerine, shortening, and salad and other cooking oils. Availability of "added fats and oils in total" (which includes butter & lard) has doubled. There is no available data for fruit and fruit juices and caloric sweeteners, but the data that is available for later periods indicates steep increases. The authors have chosen a few of data points that show decreasing consumption, from an article that supports overall increases in energy intake and large increases in consumption in other areas. This is cherry-picking and deceptive.

I looked into a couple of other citations and found similar evidentiary practices: over-interpretation, cherry-picking, extrapolation, and just general sloppiness, all in service of dismissing entire fields of study and supporting their overall narrative that no one has any idea what is going on. This is an incredibly complex area to study, and the causes are likely to include some combination of multiple factors, which change over time and impact different people differently. Failing to attribute the entire rise in obesity to a single factor doesn't mean that one can simply dismiss it as a possible contributor.
posted by googly at 10:30 AM on July 12, 2021 [48 favorites]

Thank you, googly.

(I came back because a factor I forgot to mention is constant smoking. Cigarettes kept you thin, everybody knew that, and everybody also knew you'd gain weight while you tried to quit. But even so, it can't have been the only factor.)
posted by Countess Elena at 1:46 PM on July 12, 2021 [9 favorites]

There seem to be two possible conclusions about CICO that would be good to clarify.

1. It's completely wrong, and the body can discard unnecessary calories, either by raising metabolism or excreting undigested calories. This would be the more interesting, it would point more to some x factor, and it might be easier to mitigate.

2. It's not even wrong, in which the body perfectly absorbs calories and stores the surplus. If this is the case, it's only useful in that it eliminates #1. You'd still need to examine why people are consuming more calories, or expending less. Plenty of suspects there - food is cheaper, more calorie dense, engineered by corporate scientists to be craved, and served in larger portions. The types who smugly say CICO in every diet thread are blaming the user and not the pusher.
posted by condour75 at 3:38 PM on July 12, 2021 [2 favorites]

CICO is a truthism, and would only be really useful if CI were some number that is an unquestionable measure of "the available (to your body) nutrients from these foods that you ingested, after your body has finished processing them" and CO were an easily obtained measure of "the energy cost of these activities you performed, plus these biological processes your body carried out".

Saying "CICO" is basically saying "eat less, until you see a negative change in weight, which may or may not be sustainable on either a quality-of-life or a physiological level, we don't give a shit".
posted by tigrrrlily at 3:50 PM on July 12, 2021 [8 favorites]

Saying "CICO" is basically saying "eat less, until you see a negative change in weight, which may or may not be sustainable on either a quality-of-life or a physiological level, we don't give a shit".
Or, more charitably, “eat less, exercise more” is true but you need to find a formulation which works for you over the long term. I used that approach to lose (and keep off) a bit over 100 pounds two decades ago. It was useful both for a reminder that the bad food moralizing wasn’t helpful (it’s okay to have bacon or ice cream, just have less and avoid running a long-term surplus), you don’t need expensive fad foods, and that things other than running marathons still count for increasing your total daily expenditure.

No, it’s not really that simple but it’s enough to work as a mental model for many people giving real results. I’d generally put my anger into the way our environment has been rearchitected to remove routine exercise and nutritionally-void foods are heavily subsidized.
posted by adamsc at 4:27 PM on July 12, 2021 [11 favorites]

I keep drinking a quart of motor a day and don't put on any weight. That's like 1500 calories! Beginning to doubt this CICO theory.

To be less snarky; it's not just calories, it's available calories. Burning stuff in a crucible is not anything like human digestion. Another major change in our diet is the increase in processed foods where the calories are more quickly available. There's lots of theories about that being tied to global weight gain, maybe in connection to insulin response. The article gets close to several of those theories and dismisses them but I'm not entirely convinced.

(Thanks to the recent posts like googly and ssg who've posted detailed criticisms of the article. It's a much more interesting discussion when it's informed by the reading!)
posted by Nelson at 4:29 PM on July 12, 2021 [5 favorites]

eat less, until you see a negative change in weight...

This is doable. I have done this. I have done this for the two years it took to reduce my bodyweight to about 60% of what it was before I started doing it, and then spent three years thoroughly enjoying the increased physical mobility that came from that. I've been fat, and I've been lean, and lean wins. No question.

...which may or may not be sustainable on either a quality-of-life or a physiological level...

The thing about quality of life is that it's not a one-dimensional measure. If it was reducible to some kind of overall score, then I can tell you for a fact that being lean felt so much better to me than being fat ever has, by pretty much any physiological criterion, that I would still be lean today.

But the price for reaching and maintaining that leanness was making it all that I thought about. And it's that degree of totally obsessive focus, and the personality changes that came along with it, that I found unsustainable. I cannot do that and still have anything that looks like a life; it permanently consumed all my spoons and turned me into an obnoxious, unbearable control freak.

I know exactly how much constant conscious control it takes to override my body's automatic regulatory systems sufficiently well to get lean again, I know exactly what extended exertion of that degree of control costs me mentally and emotionally and intimately and socially, and it's too much. Being fat hurts more and may well shorten my life, but I can live with fat me and I'm really not sure that I could with leanness-obsessed me.

...we don't give a shit

has been the apparent underlying attitude of every lean medical practitioner I've ever had anything to do with. The fat ones totally get it, which manifests as not starting to give me grief about my obesity the moment I walk in their doors. But one of the tradeoffs for a bucolic life in rural Australia is that the local doctors are something of a rotating cast; my nice fat doctor moved away some years ago now and I have yet to find another with whom I feel comfortable.

This is why I'm no longer talking to lean people about obesity.
posted by flabdablet at 4:34 PM on July 12, 2021 [27 favorites]

despite the two of us having lived radically different lives and despite having different philosophies towards cooking and eating

I EAT TAPAS, please, please tell me that your brother is really emphatic about not eating tapas.
posted by evidenceofabsence at 7:56 PM on July 12, 2021 [12 favorites]

The link in the op is to a science blog, so the audience isn't quite 'general interest', and so my gripe doesn't strictly apply to this instance, but my issue with this type of journalism is that it condenses the science so much that it can actually discourage people from trying to lose weight. It may be that the science has difficulty explaining society's propensity to obesity over the decades. It is a fact that it is very difficult to lose many dozens of pounds and keep them off. But it's very possible to lose say 10% of your total poundage if you're overweight and keep it off, which will have immediate and noticeable positive impacts on one's life, even though one might still be far from that mystical 'normal bmi' line. And I say this as a fat person who was for too-long stymied by the all or nothing thinking perpetuated by articles like this (but perhaps not this article).
posted by sid at 8:51 PM on July 12, 2021 [10 favorites]

The problem with "eat less" is that all humans eat a specific amount of food per day (about 3-4 pounds - for more info, see the work of Barbara Rolls, the endowed Guthrie Chair of Nutrition at Penn State). The trick is not to eat less! We NEED to feel satiated, not deprived. The trick is to eat food with lower calorie density, which is generally the food with the highest water and fiber content. You don't have to count calories when eating low calorie density foods. You don't have to exercise like a mad unhappy fiend, because it is the food that makes the majority of the difference in weight loss. (Exercise has a ton of other benefits and we should all do it more if we can.)

Giant food conglomerates could not give half a sh!t whether they provide decent nutrition - their only goal is profits, even if that means hiring teams of scientists to craft insanely unhealthy super-processed cocktails of fat, sugar and salt to keep us addicted to their crap. Meanwhile, Big Ag and Dairy have convinced us that meat and dairy three times a day is normal when it is so, so very much not normal. And that's before you get to the hormones, antibiotics and other intentional and unintentional disgusting crap that goes into the bodies of farm animals before they are slaughtered.

Want to do yourself the biggest favor you can today? Cut your dairy drastically. I understand this is difficult. I do understand. But humans are so very adaptable. All of us. I did this a year ago and everything is better now. And once you do that, you may be more open to finding out exactly what the horrific life of a dairy cow is like, which will strengthen your resolve. And of course the processed foods. Avoid whenever possible.

Finally, CICO is an inexact science because some bodies due to genetics are better at storing fat because in our distant past this was an excellent way to survive long periods of food scarcity. Two people CAN eat all the same foods, and one will carry more weight. But the trick of calorie density does work for ALL types of bodies. Our genetics are not our fault. Terrible and unethical practices of the food industry are not our fault. But there ARE things we can do about it.
posted by Glinn at 5:32 AM on July 13, 2021 [4 favorites]

the trick of calorie density does work for ALL types of bodies.

I can tell you for a fact, based on personal research and experience, that it doesn't work for all types of people.
posted by flabdablet at 5:38 AM on July 13, 2021 [13 favorites]

I think where I'm struggling with this discussion is that I'm over 50, and I know a lot of overweight and obese people as well as working with super fit and dedicated people in the fitness industry.

And...I just don't see a difference in knowledge or will power between the two groups. Like, at all. (And by the way they're not always separate groups, it's a Venn diagram.)

The people who are overweight tend to be MORE up on the latest theories around weight and food and have generally tried more things. (It may be that the trying is bad, as we all probably know.) Overall, in terms of life skills, even accounting for age, I would say that the fitness people have less planning ability...not because they are stupid or anything but they've chosen a life path that is very immediate, where they come in, teach a great class, and go home and are not planning projects to make sure people in a flood can still access their bank accounts.

So when I see advice like "eat food with more volume!" I just want to scream on behalf of all of us because it betrays the idea that fat people just Don't Know What Thin People Know or whatever and...it just does not match my experience with people. I know I personally have less willpower than my nurse friend who had bariatric surgery, because I drown my sorrows in chips and she goes out and dances her heart out at amazing music festivals (pre-Covid) and camps and eats sensibly.

But her body fights her every step of the way and mine does not.
posted by warriorqueen at 7:50 AM on July 13, 2021 [23 favorites]

Yup. I've had the same experience as flabdablet; I'd certainly rather be slim than fat, it makes it a lot easier to be physically active and it's less hard on the joints, but overriding my body's set points is permanent unrelenting misery. So after several decades of failed off and on dieting (and bouncing back to a higher weight every time), I decided some years ago to prioritize my mental health.
posted by tavella at 7:55 AM on July 13, 2021 [7 favorites]

People love to attribute things which are largely due to complicated intersecting factors of systems laughably far outside of individual "control" to their own alleged individual merits.

People also love to take complicated intersecting systems and find the One True Simple Thing that makes them not worryingly complicated. (Sometimes there really is one, and people just haven't found it yet! I'm sure I've nattered on about the metaphorical oomph of what made orbital epicycles "go away"--part of the oomph here is that part of it taking awhile to figure out is people are very loathe to let go of alleged cutting-through-it factors that aren't correct.)

Those two things don't perform great on their own, and get even worse when mixed.
posted by Drastic at 9:35 AM on July 13, 2021 [4 favorites]

I don't want to argue with anyone, but the volume thing was mine, so I do feel like I need to add that I was fat and depressed just about my entire life, from elementary school to the age of 51. I did weight watchers 4+ times, cabbage soup diet, pectin pills, Doctor's Quick Weight Loss Centers (remember that one?!), Jenny Craig, over-exercising, Slim Fast and my parents sold the Cambridge Diet plan for a time. My parents and my sisters are/were obese. I know as well as anyone that change is fiendishly hard, diets are terrible and don't work, and most people fail at this most of the time because the decks are stacked against us. I'm truly sorry if I made anyone feel worse. I will stop posting here but anyone can feel free to send a memail.
posted by Glinn at 9:37 AM on July 13, 2021 [4 favorites]

FWIW, my doctor told me to prioritize my mental health.
I also think it is interesting to read about Glinn's experience, and I can understand the urge to shout it out over the roofs when one has finally found something that works -- for one self.
We all probably have very different things we can live with or can't live without. Every time people start paleo'ing at me, I zone out. I cannot be happy without gluten. I can be content with a very small amount of bread or pasta every day, but entirely without those foods, I would be miserable. So regardless of the scientific merits or not of that lifestyle, it will never be mine (well, unless I develop coeliac disease or something). For others it might be something else you need for happiness, just look at the coffee thread!
As stated above, right now I've started trying to eat my six vegetables and fruits / 30 grams of fibre a day, not for slimming reasons, but because it may help me manage my mental health issues. For me, it feels like a volume-diet, and I find it very hard to handle. Today has been a hard day at work and I really don't feel like cooking and eating three servings of vegetable, when I could just have penne alla gorgonzola.
I've only just begun, so the verdict is still out on wether I will be able to live with it. Because regardless of what it is, so many comments here show that it is not enough to lose weight on a diet, you need to be able to build new habits, which is much harder.
posted by mumimor at 9:52 AM on July 13, 2021 [4 favorites]

The third installment is out, and adresses a lot of the questions we have asked in this thread.
posted by mumimor at 1:12 PM on July 13, 2021 [4 favorites]

CICO is a truthism, and would only be really useful if CI were some number that is an unquestionable measure of "the available (to your body) nutrients from these foods that you ingested, after your body has finished processing them" and CO were an easily obtained measure of "the energy cost of these activities you performed, plus these biological processes your body carried out".

The article keeps implying (even in the latest article) that CICO is a number that can be accurately measured across time and has not changed dramatically, hence the search for environmental cues.

Also: just for fun, here'a silly review of potato guy while the stunt was going on:
Eater: Shocker: Man Now Regrets All-Potato Stunt Diet
posted by The_Vegetables at 2:38 PM on July 13, 2021 [1 favorite]

Glad for the third installment but I find the speculation much less convincing than the summary in parts one and two. Yes, an environmental contaminant is possibly a culprit. No, it doesn't fit all the facts perfectly. But more importantly; what contaminant? Or at least, by what mechanism? I guess we have to stay tuned for part four.
posted by Nelson at 3:01 PM on July 13, 2021 [2 favorites]

People also love to take complicated intersecting systems and find the One True Simple Thing that makes them not worryingly complicated. (Sometimes there really is one, and people just haven't found it yet! I'm sure I've nattered on about the metaphorical oomph of what made orbital epicycles "go away"--part of the oomph here is that part of it taking awhile to figure out is people are very loathe to let go of alleged cutting-through-it factors that aren't correct.)

People are really loathe to believe that x could be caused by many different things. We see this with mental health all the time. First it was psychodynamic, it's always your childhood. Then it was always a chemical imbalance. Now the new trend is that it's always capitalism and impending climate disaster. Except maybe for some people it is because their parents treated them like shit, and for other people it's because their brains don't make enough serotonin, and for others it's because their job is inhumane and the air is filled with smoke. And maybe for some people it's all three, or something else entirely!

Maybe it's the same for weight. Maybe for some people weight gain/loss IS due to diet/exercise. This provides us with enough "examples" to sustain the idea that it's the One True Way when actually it is only the one true way for some people, and maybe we should believe people when they say it didn't work for them because for them it's a different cause or set of causes. I think people hate that idea because they want it to be one easy thing to control, but when has anything EVER been that easy?

Also, re: the most recent post: one of the theories for weight gains on psych drugs is basically, "You're no longer miserable and non-functional so now you're eating like a normal person should." Which sort of implies that the weight a person was before taking the psych meds... was the unhealthy one? If that's the weight you're at when consistently undereating because you don't care and can't enjoy anything. It may have appeared to be a "normal" weight, but it was clearly unhealthy for YOU. But no one actually reasons like that because the idea that maybe some people need x amount of food to be functional, and x amount of food will make them fat even if they're eating healthy and exercising, is not a popular one.
posted by brook horse at 4:11 PM on July 13, 2021 [11 favorites]

I just don't see a difference in knowledge or will power between the two groups. Like, at all.

Me either. And well put.

I can understand the urge to shout it out over the roofs when one has finally found something that works -- for one self.

Indeed. I've done that very thing myself with intermittent fasting, both with and without the use of progress-tracking charts - which worked for me really, really well for a while, until it didn't. I've dropped around 30kg twice with those tools.

Part of what makes any of these things work, I think, is the fact that getting exciting early results with them at an acceptably low physical and emotional cost brings on exactly that Finally, This Is The Thing! motivator, conferring an optimism and a momentum that makes the continued paying of that low physical and emotional cost acceptable for a while.

And maybe one day I will try something that really is The Thing for me. I'm truly happy for you, Glinn, that you seem to have found one for you.

As for making people feel bad: the way to avoid that, it seems to me, is not to shut up entirely about what's worked for you, but rather to be conscientious about presenting it as a thing that has worked and/or is still working for you, rather than framing it as if it were the thing.

On the Internet, nobody knows you are or have been fat unless you say so, and accounts of The Cure presented as if they were objective truths are very hard to distinguish from the relentless barrage of thinsplaining that's pretty much the universal experience of fat people.

I'm quite sure there are people reading this thread right now who have not tried the volume thing, and for whom it would work every bit as well as it has for you, and who will spend many years feeling grateful to you for bringing it to their attention. Well worth the risk of a bit of pushback from the likes of me, I'd have thought.
posted by flabdablet at 8:43 PM on July 13, 2021 [5 favorites]

The third installment is out

(clicks link)

ctrl-F endocrine disrupt

(found in section 3.3)

Uh huh.
posted by flabdablet at 8:53 PM on July 13, 2021 [3 favorites]

> unless a key, but invisible event took place in 1976, it is highly unlikely that BMIs all started rapidly increasing, just like that, all of a sudden. The charts in the first article are shocking, not because of the increase in obesity, but the suddenness of the change.


> Coincidentally, the wealthier people are, the longer-lived, taller, thinner and healthier they are, and by some other incredible coincidence, the more unprocessed their diets and less polluted their environments (and vice versa for poor people).

Hmm, perhaps not coincidentally, here is another chart that seems to take a sharp turn to the right in the mid to late 1980s: GINI Index for the U.S. 1975-2018. Here is a graph of the GINI index in English-speaking countries with a U shape that bottoms out right pretty dramatically in the late 1970s (source).

It is a better guess than most that this does, indeed, have something to do with it. It would probably have to be linked with other co-factors, like the rise in ultra-processed foods as the primary foods available to people in the lower income rungs.
posted by flug at 9:55 PM on July 13, 2021 [4 favorites]

Wow, that third installment gets pretty hand-wavy. First it's altitude, so obviously it's something in the water, then it's obviously food because Cuba (ignoring that Cuban caloric intake fell by something like a third in the special period). The author is arguing in circles: obviously, it's not caloric intake because [hand-waving], so any evidence of weight changes at a population level can't be due to changes in caloric intake or exercise, so thus it must be whatever ideas he's come up with.

I'm not saying that there might not be some factor or combination of factors in our environment that is contributing to obesity, but this kind of argument doesn't really tell us anything.
posted by ssg at 1:29 PM on July 14, 2021 [1 favorite]

flabdablet, I am right now at what is probably the very bottom of a trough in weight, having been steadily losing for the past two years. I don't expect it to last. I don't know how it will go wrong exactly, yet (I have some guesses), I just don't see a reason why I would be one of the "special" ones who manage to die while still thin.
I don't get out much, and when I do it's mostly for solitary exercise, but just putting myself out there in the world the way I am now feels like false advertising. No, you people looking at me with envy / admiration most likely can't do what I just did without my considerable privileges, and why would you? It was and is miserable, and it won't last, not for me and not for you. But in the meantime people whose opinion I should not care about *do* treat me better, and most importantly that dark, sexist, size-ist little corner of my mind is positively over the moon when I look in the mirror. I can just click "medium" when buying athletic gear online and it will just magically fit (I'm currently 9th percentile for age and height, so there's a doozy for you). So I'll just soak all that up as long as it does last.
posted by tigrrrlily at 7:44 AM on July 15, 2021 [3 favorites]

steadily losing for the past two years

That takes grit and determination. Well done you.
posted by flabdablet at 8:53 AM on July 15, 2021

It's always fun when the author of the link winds up reading the thread. Their callout has a pleasantly mid-aughties feel to it.
posted by fantabulous timewaster at 1:42 PM on July 17, 2021 [4 favorites]

The total health and climate consequences of the American food system cost three times as much as the food itself
According to the report, if U.S. rates of diet-related diseases were reduced to similar rates in countries like Canada, health care costs could be reduced by $250 billion per year.
This would require the food industry to focus on creating healthier foods and adhering to more rigorous regulations for the marketing of unhealthy foods, said Roy Steiner, senior vice president for the food initiative at the Rockefeller Foundation, which funds an array of initiatives and nonprofits.
“We created the food system with a particular objective — low-cost and abundant calories — and we didn’t understand what that impact was going to be,” said Steiner, one of the authors of the report.
Separately, the report also suggests that if the United States could reduce agricultural greenhouse gas emissions to keep the global temperature increase below 1.5°C of preindustrial levels, then some $100 billion could be saved in additional environmental costs.
posted by mumimor at 4:51 PM on July 17, 2021 [1 favorite]

A Chemical Hunger – Part V: Livestock Antibiotics

they seem pretty sober in discussing their first candidate, but the episodic, teaser format isn't doing them any favors. i'm still 30% expecting them to end with a Ripper-esque "Ice cream, Mandrake. Children's ice cream."
posted by logicpunk at 2:51 PM on July 20, 2021 [4 favorites]

It's not that the idea that environmental factors can be part of the explanation is entirely meaningless, and I am personally very worried about the antibiotics and pesticides for many reasons, but can this theory explain the fact that coastal/urban populations in the US are less obese than suburban and rural populations, across class, race and gender differences? It may be that the coastal elites eat vegan organic food and drink pure spring water, but most people eat out or get takeout several times a week and few restaurants serve only vegan organic food, so ordinary people cannot be in control of the sources of their food and drink.
Scandinavia, where I live, has far fewer obese people than the US, but agriculture is heavily industrialized and depends on antibiotics, fertilizers and pesticides. It is far more regulated than the US today, but in the 1970s and -80s that wasn't the case. Water is probably better protected, but again, it wasn't always that way, and actually there are more obese people today than there were when pollution of food and water were worse. As in the US, the obese Scandinavians mostly live in the suburbs and rural communities, and they eat a lot of processed food, from supermarkets or from chain restaurants.
Looking at the global obesity index, I feel transportation must play a major role. I don't know about the culture in the Pacific communities at the top of the index, maybe someone else can weigh in here, but the next many (+30) countries, are countries where a large proportion of the population are dependent on cars, rather than public infrastructure. Obviously cars can contribute to obesity both by limiting exercise and by polluting air and water.
Also, the populations in Kuwait and Jordan (the countries on both sides of the US on that index) are not likely much affected by the same environmental conditions as the population in the US, except for the effects of car-based transportation. Industrial agriculture is not a factor in any of those countries, and while obviously no one eats pork, beef and veal are also quite rare meats in the general population. Although American style food is popular in both countries, I find it difficult to imagine that processed food it eaten widely enough across the populations to lead to US levels of obesity.
Going back to the Scandinavian countries I know best, it is thought provoking that the level of obesity exactly follows the level of car dependency in the countries, with Norway "leading" and Denmark at the lowest level of obesity.

An other common factor I can think of is consumption of soft drinks (sweetened with sucrose or artificial sweeteners). Soft drinks are very popular in Muslim majority regions, and they are high on the list. If one makes a cut at 20% obesity in a country, most countries below that line are so poor and unequal that drinking too much soda on a population scale can't be an issue, but those countries that are not poor, but are below the line, have food and drink cultures where sweet drinks play a lesser role or are local and less sweetened, for different reasons.

A third question is how extremely poor countries still mange to have high levels of obesity? I'm looking at Haiti, Cuba and probably those Pacific nations that are on the top of the list. And many more. Those examples suggest that poverty isn't the only explanation for the lack of obesity in many African nations and in South and East Asia. I haven't made my own spreadsheet to actually compare the numbers, but I feel the both the genetic argument and the environmental argument are compromised by this as well.
posted by mumimor at 4:11 PM on July 20, 2021

What if it's all those things? What if it's contaminants and easier availability of calories and less exercise because of transportation and and.. All these things together, each contributing.

Part IV sort of hints at that
If we’re not lucky, the obesity epidemic is the result of dozens or even hundreds of different contaminants
Only maybe it's more than just contaminants. Way back at the very beginning of this conversation I said
It's going to turn out to be some complicated systemic response but there will be one basic causative thing that can be altered
I recognize that now as wishful thinking. I mean it'd be great if it were true, that one single change in something would make a lot of people healthier. And maybe it will work out that way. But there's no particular reason to think that it will be like that.
posted by Nelson at 4:56 PM on July 20, 2021 [3 favorites]

Another suspect: Part VI: PFAS
posted by gakiko at 2:59 AM on July 27, 2021 [1 favorite]

If we stick with this all the way to the cliffhanger at the end of Season 1, I'm tipping that PFAS will be the poorly lit figure rising up in the back seat of the car.
posted by flabdablet at 3:43 AM on July 27, 2021 [1 favorite]

If there were a discrete chemical cause it would stick out. Workers in the first factory to make it would show early symptoms, and you'd be able to track its spread throughout the world by correlating weight with industrial production.

No, if we're going to pick some hand-wavy factor to do with modern civilisation it has to be something that appeared out of nowhere, essentially, and spread rapidly. I'm going to say carbon-14, because why not. The level of C-14 in the atmosphere doubled as a result of nuclear testing back in the 1950s. We know that different isotopes can have subtly different biological properties, ergo, it's C-14, where is my Nobel.
posted by Joe in Australia at 5:13 AM on July 27, 2021 [1 favorite]

Maybe it's lupus!
posted by flabdablet at 6:23 AM on July 27, 2021 [4 favorites]

I'm getting frustrated with this series too. I lost it at "Maybe PTFE really is that inert. We find it a little hard to believe." Uh, OK?

The idea that PFAS chemicals might be related to obesity is hardly new. And the author does a reasonable job covering a bunch of statistical information that points to a potential correlation. To Joe in Australia's point they do try to pin production directly to a spread of obesity, at least for PTFE in West Virginia. But they can't find the data they need so instead they leap to "Unfortunately we don’t have obesity data for West Virginia ... But we can note that many years later, West Virginia was at the center of the first legal action surrounding PFAS." But the legal action has nothing to do with obesity; so why bring it up?

I still respect the collection of facts but the author is working too hard to imply a conclusion there is no clear evidence for. And then all of this is statistical correlation; nowhere is there any hint of causation. What chemical pathway might link this kind of environmental contaminant to obesity. IIRC that research also exists and is inconclusive, but it's not in this article.

Anyway I still think a theory like this one with PFAS is plausible. Maybe this article will inspire a more meaningful investigation.
posted by Nelson at 7:31 AM on July 27, 2021 [1 favorite]

PFAS have been linked to the increase in hyperthyroidism in cats. (This is just an example study. There have now been a number of them linking PFAS to this troubling veterinary trend.)

These large, stable molecules have all kinds of potential interactions with the endocrine system, and there are so many different molecules that fall under the PFAS umbrella that it's really hard to study the actual biochemical mechanisms unless some link is made to a specific molecule.
posted by hydropsyche at 8:55 AM on July 27, 2021

If there were a discrete chemical cause it would stick out. Workers in the first factory to make it would show early symptoms, and you'd be able to track its spread throughout the world by correlating weight with industrial production.

Counterpoint: Proving that leaded gas causes lead poisoning was incredibly difficult. The gas companies published lots of reports declaring it was safe, and pushed the idea that there was a base amount of lead in humans naturally. Turns out there kind of was, but only because everybody was poisoned by the crap in the air... It took archaeological chemistry to demonstrate that things has changed.
posted by kaibutsu at 5:41 PM on July 27, 2021 [8 favorites]

Interlude B: The Nutrient Sludge Diet
This is a weird and funny interlude. I think the authors forget that a lot of diets are based on living on Nutrient Sludge of some sort, so if you use the right search terms, there is probably more science out there than they acknowledge. I don't know the right search terms, though, since this is very far from my own field of work.

Related, but should probably have its own FPP: Man v food: is lab-grown meat really going to solve our nasty agriculture problem?, a Guardian Long Read by Jan Dutkiewicz and Gabriel N Rosenberg
In the context of this thread, I took note of these numbers:
For consumers, the current food system is defined by abundance and low prices. Americans spend just under 10% of their disposable income on food, among the lowest rates in the world, and eat a whopping 122kg of meat each a year, including 55kg of chicken. (For comparison, in the UK the numbers are lower but still unsustainable, at about 80kg of meat per person, including 32kg of chicken.)
It's a bit hard for me to find the equivalent numbers for different countries. I can find that in 2013, Danes ate 48 kg of meat on average (international statistics can show other numbers, because they don't take into account that most meat produced in Denmark is exported, and that might to some extent also apply to the US numbers). This was before the links between animal food production and climate change became widely known, and judging from media coverage and supermarket aisles the number may be further reduced today.
Apart from the basic fact that meat-based food is often more calorific than plant-based food depending on preparation, this could again also point to the overuse of antibiotics in industrial food production. Not least because use of antibiotics is less regulated in the US than in the EU. (And probably the Pacific Islands import a lot of their meat from the US).
Also, meat consumption as well as obesity may be very un-evenly distributed in different countries. Where in the US and UK, obesity is more prevalent in lower income groups, but basically an equal opportunity ailment, in Arab nations and countries like India, poor people are still skinny people, like in the old days. And that could be a reflection of both meat consumption and access to motor vehicles.

I'm stil mostly inclined to think there are many different reasons combined, rather than one clear answer. The other day, I was looking at some old music videos, and the artists were indeed very skinny, even compared to the superfit superstars of today. Something has changed.
posted by mumimor at 3:19 AM on July 29, 2021

Related, but should probably have its own FPP: Man v food: is lab-grown meat really going to solve our nasty agriculture problem?

psst, it does now
posted by bitteschoen at 5:02 AM on July 29, 2021 [1 favorite]

For anyone still following: another suspect.
posted by gakiko at 6:17 AM on August 6, 2021 [4 favorites]

« Older Dear Queer Dancer   |   a hall of fame collecting the "most iconic" Tumblr... Newer »

This thread has been archived and is closed to new comments