Physicians should no longer recommend weight lose

[Nutria]

Did you read the rest of what I wrote? Statistically dieting leads to long term weight gain, not loss. The average female starts their first diet in elementary school, and as a nation we keep getting bigger. There's most definitely a connection.

How in the world do you get "Nutria thinks we must all crash diet" from "we did it to ourselves"??

[hamchan]

How in the world do you get "Nutria thinks we must all crash diet" from "we did it to ourselves"??

I didn't? I'm saying it doesn't matter whose fault it is, dieting is part of the problem.

[hamchan]

hamchan, I worked 12 hours today so haven't been online. I haven't had a chance to look at the links you posted so I'm not sure if they address this question.

If, as you say, obesity is all biology based and losing weight is impossible, what explains the dramatic increase in obesity over the past couple of decades? Nothing has changed in our biology to my knowledge. Humans are pretty much the same as they were 20 or 30 years ago. So if it can't be explained by increased calorie intake and decreased physical activity, why are so many people so much heavier today?

Just to clarify, losing weight isn't impossible, keeping weight off long term after losing it is more than the vast majority of people are capable of doing.

I'd encourage you to read the links and check out the book I recommended, as the book addresses the question you had. The bottom line is that "we don't really know" but we have found that even labratory animals, whose diets are tightly controlled, weigh more than they used to. There are a variety of other factors being looked at and studied as well. It's not a simple answer, and it's not really known.

Given that people are dieting more than ever before, and starting earlier than ever before, and dieting is associated with weight gain and increased risk of obesity in the long term, I'd be taking a hard look at that as well. We'd probably weigh a whole lot less on average if we stopped trying to lose weight in the first place, especially kids and teens.

[Nutria]

Did you read the rest of what I wrote? Statistically dieting leads to long term weight gain, not loss. The average female starts their first diet in elementary school, and as a nation we keep getting bigger. There's most definitely a connection.

I didn't? I'm saying it doesn't matter whose fault it is, dieting is part of the problem.

I never asserted "dieting is good and necessary". Thus, your confrontational "Did you read the rest of what I wrote?" is a non sequiter to "we do it to ourselves".

EDIT: the title of this thread is not "Physicians should recommend dieting". Your whole string of comments on how bad dieting is is completely OT from whether or not people should lose weight.

[disneysteve]

keeping weight off long term after losing it is more than the vast majority of people are capable of doing.

"capable" or "willing"? Those are two entirely different things.

Given that people are dieting more than ever before, and starting earlier than ever before, and dieting is associated with weight gain and increased risk of obesity in the long term, I'd be taking a hard look at that as well. We'd probably weigh a whole lot less on average if we stopped trying to lose weight in the first place, especially kids and teens.

This is pure nonsense. People are "dieting more than ever". What constitutes "dieting"? I have patients tell me all the time that they are "dieting". When I actually dig into what they mean by that and what changes they've made, most of what they're doing isn't any better, and sometimes is even worse, than what they were already doing.

Example: Speaking to one patient I learned that she drinks beer regularly. She's not an alcoholic. I don't believe she has any addiction issue. She just happens to like beer, so whenever she goes out to eat, which she does a lot, she gets a beer with her meal. I showed her how many calories are in that beer and how beneficial it would be to drink water instead. She comes back a couple of months later excited to tell me that she "followed my advice" and stopped drinking beer when she went out. I congratulated her for that, despite noting that she had gained about 5 pounds. She then proceeded to tell me that in place of a beer, she was getting a margarita. In her mind, she was "dieting". Had a research company called her, she would have said, "Yes, I am currently on a diet." That would have totally ignored the fact that her idea of a diet was substituting a 350 calorie margarita for a 150 calorie beer.

To say that we don't know why more people are obese is inane. Numerous studies have shown that average daily calorie intake has increased by something like 300 calories. That's an extra 110,000 calories/year. Of course people are heavier than they used to be. People no longer cook from scratch. They eat a diet primarily composed of processed foods. And they are more sedentary than ever.

Serving sizes have grown dramatically as well. In the 1960s, McDonald's sold one size of french fries that was about 200 calories. Today, a large has 510 calories. A regular burger, small fries, and small Coke is about 620 calories which isn't terrible, but nobody actually does that. Instead, they get a BBQ bacon burger, large fries, and large coke of 1,220 calories. And to top it off, they get dessert to go, a McCafe shake, which adds another 510 calories bringing the meal to a whopping 1,730 calories. And then they come and tell me, "I don't know why I'm gaining weight."

When CocaCola was first introduced, it came in one size, a 6-ounce bottle. When I was in high school, I worked at a snack bar. We had 3 sizes of soda. The large was 12 ounces and we didn't sell that many larges. Today, a "small" at most places is at least 16 ounces and often more than that.

Another study found that Americans get about 8% of their daily calories from sugary drinks and about 16% from added sugar.

Yet another study found that the average adult weight worldwide (in developed countries) was 137 pounds. The average in the US was 180 pounds. Clearly, Americans are doing something differently that is making them the fattest on the planet. It's not a secret.

[disneysteve]

We went to Canada a number of years ago. Early in the trip, we went to a local amusement park. At lunch, my plan was to do what we normally do and get one drink that the 3 of us share. So I ordered one Coke only to be handed a cup that couldn't have been more than 8 or maybe 10 ounces. They didn't have small, medium, and large. They had one size.

A day or two later, we were in Niagara Falls. It was hot and we needed to cool off. We saw an Icee stand and decided to get those. We were deciding what size we each wanted only to walk up to the counter to find that they also had just one size, what Americans would probably call a "kid's", not even a small.

Throughout the trip, we encountered the same thing over and over. Serving sizes were very reasonable and, as a result, obesity in Canada isn't nearly the problem that it is in the US. One time we even stopped at a vending machine on the street to get a drink, expecting a 12-oz can to pop out. Nope. It was one of the short 8-oz cans.

Anybody who says they don't know why 70% of Americans are overweight or obese is simply not paying attention.

[Nutria]

She comes back a couple of months later excited to tell me that she "followed my advice" and stopped drinking beer when she went out. I congratulated her for that, despite noting that she had gained about 5 pounds. She then proceeded to tell me that in place of a beer, she was getting a margarita. In her mind, she was "dieting". Had a research company called her, she would have said, "Yes, I am currently on a diet." That would have totally ignored the fact that her idea of a diet was substituting a 350 calorie margarita for a 150 calorie beer.

She votes and breeds, too, huh?

[Gailete]

hamchan, I worked 12 hours today so haven't been online. I haven't had a chance to look at the links you posted so I'm not sure if they address this question.

If, as you say, obesity is all biology based and losing weight is impossible, what explains the dramatic increase in obesity over the past couple of decades? Nothing has changed in our biology to my knowledge. Humans are pretty much the same as they were 20 or 30 years ago. So if it can't be explained by increased calorie intake and decreased physical activity, why are so many people so much heavier today?

One of my hobbies is collecting cookbooks and reading them. Yes, seriously I read them and look at many or the recipes. Over the years of reading cookbooks from the early 1900's to current time shows some interesting facts that most people are missing in wondering why Americans get so fat.

1. The big ones is so few people cook from scratch anymore and they then eat high calorie, high sodium fast food.

2. Cookbooks have gotten on the band wagon of trying to lower fats, salt and sugar in the diet, so many cookbooks are taking old recipes and remaking them into 'healthy' recipes.

3. Way back when, people put out so much more energy to earn the cost of grocery or work hard in their gardens to grow their food. Many, if not most folks are certified couch potatoes.

4. Eating a low-fat meal with severe portion control, means a person wants more to eat within an hour and so then they open a bag of chips and a soda as well as other goodies.

5. I really think that if people would one learn to cook and throw out those low fat, low sugar, low salt, low taste cookbooks and start using a Betty Crocker or Better Homes and Gardens cookbook main cookbook from the 1950's, people might eat and get more fat/salt in their diet during a meal, BUT they wouldn't have that need to pull out snacks in no time after a meal. By doing so, they would actually reduce the amount of sale, sugar, fat in their diet significantly over the course of time.

@Steve, when I have visited Canada, I have noticed the same thing. Much skinnier people.

[disneysteve]

The big ones is so few people cook from scratch anymore and they then eat high calorie, high sodium fast food.

I really think that if people would one learn to cook and throw out those low fat, low sugar, low salt, low taste cookbooks and start using a Betty Crocker or Better Homes and Gardens cookbook main cookbook from the 1950's, people might eat and get more fat/salt in their diet during a meal, BUT they wouldn't have that need to pull out snacks in no time after a meal.

The #1 cookbook in our house is Better Homes and Gardens and our edition is probably from the 70s.

I agree that all of the "diet" foods are part of the problem.

Even cookbooks depend heavily on processed foods. Most things sold as cookbooks are little more than assembly manuals today, putting together a bunch of prepared foods to make a meal.

[~bs]

RE cooking

Agreed totally. I cook mostly from scratch (WAY cheaper than eating out), and it's only after cooking do you realize how insane restaurants are when it comes to sodium and fat used in preparation. I CAN season the food to taste like how theirs tastes, but CHOOSE not to because I'm conscious of the absurd amounts they use.

---------------

i've been to japan and multiple other countries in asia. The populations are largely slender. The difference is smaller meals and more exercise. In fact, in Japan, despite eating "like an american" the entire trip, I actually came back leaner and lighter than when I left on the trip. In fact, several of my friends I traveled with commented something similar.

The amount of walking one does in Japan is quite impressive. After we finished our meal, we'd be off walking to the next destination. Maybe it's kinda bad, but Japan isn't the best on handicap accesibility either. It's up/down stairs and hills. You want to visit that 500 year old temple? It's up and down the 1000 steps you go! The constant low grade exercise meant that even with high food intake, I'd burn the calories off easily, even without resorting to "real workouts". If I actually lived in japan, I have no doubt I'd be a lot leaner LONG TERM, as I'd adjust to the cultural norms of smaller portions and more exercising (walking/mass transit vs car)

[disneysteve]

i've been to japan and multiple other countries in asia.

A number of years ago, a patient of mine went to Greece. When she came back, I asked her about her trip. What impressed her? One of the things that stuck with her the most was that nobody was overweight. Their "supermarkets" where they do their regular shopping are about the size of our gas station convenience stores. They just carry the necessities and basic ingredients for cooking and baking. No 40-foot aisle of soda and another of chips and another of cookies and candy. The other thing was that everyone walked or biked everywhere. Driving was a rarity.

[disneysteve]

A friend's post on Facebook just now reminded me of something else - Starbucks. How can a coffee shop be responsible for the obesity epidemic? Coffee is very low calorie. Even at Starbucks, a Venti (large) coffee has just 5 calories. So what's the problem? Hardly anyone actually gets a plain coffee. They get a sugary, syrupy, creamy dessert that has some coffee in it. They get a iced coffee for 140 calories or a Caffe Mocha for 290 or a Frappucino for 480 calories. And they do this every single morning on their way to work, and sometimes again at lunch or on break. I see it at my office all the time (although they go to Dunkin', not Starbucks, but same deal).

People have largely forgotten how to eat properly. And then they wonder why they can't button their jeans.

[Jluke]

hamchan, I worked 12 hours today so haven't been online.

people working longer hours and sitting in front of computers to perform their work and even carries over to computer use/phone use at home - another connection (excuse) to a shift in higher obesity rates for some folks?

[disneysteve]

people working longer hours and sitting in front of computers to perform their work and even carries over to computer use/phone use at home - another connection (excuse) to a shift in higher obesity rates for some folks?

Definitely truth to that, though I can assure you I was quite active at work yesterday. We were pretty busy so lots of time on my feet.

But your point is spot on. So much of our work is now computer-based. It leads to many people spending large chunks of their day sitting in front of a screen. That makes it even more critical not to do the same thing when you get home. Go for a walk. Ride a bike. Join a gym. Get up and move. Even playing newer video games like Wii will get you off the sofa and moving.

[Gailete]

The #1 cookbook in our house is Better Homes and Gardens and our edition is probably from the 70s.

I agree that all of the "diet" foods are part of the problem.

Even cookbooks depend heavily on processed foods. Most things sold as cookbooks are little more than assembly manuals today, putting together a bunch of prepared foods to make a meal.

I hate running into cook books that are supposed to be, say a cake cookbook, when in reality all they are is cake mix cookbooks with a few add ins to make it special! I ran into one 'beginner' cookbook and the pizza recipe absolutely floored me as it was supposedly for classic pizza as most Americans know it. Instead of mozzarella cheese it had goat's cheese, and everything else was substituted as well. This was definitely not a 'beginner' cookbook and all the recipes were like that.

Most cookbooks these days will have a recipe for 1 loaf of white bread. I taught myself how to bake out of a 1950 Betty Crocker cookbook that had survived a fire in my aunt's kitchen and made it's way to our house. I taught myself how to bake bread with a recipe for I believe it was 4 loaves and I put in my notes for making 6 loaves at once. I guess in that respect I take after my grandma. when she baked bread, she baked bread! Somewhere in the vicinity of 30+ loaves at one crack in one day! At times she would make us poor man's donuts (the poor man couldn't afford a donut cutter) and she would deep fry small hunks of bread dough and then sprinkle them with sugar and we had donuts. This grandma had to bake a lot and find cheap ways to feed kids as they had 15 of them! Seeing a recipe for one loaf of bread is rather odd to me to go through all that work and end up with one loaf and depending on how many people are near by, that first loaf can completely disappear in less than 1/2 hour! I'm not sure anything tastes better than warm fresh from the oven slice of bread with some butter melted on it, unless you can homemade strawberry jam on it as well.

Over the years it was simple things that I couldn't understand until I was watching Ming Tsai one day and he talked about getting the fishy taste out of fish by soaking it in milk. It dawned on me that over the course of years as I went from hole milk to 2% and then 1% that my tuna casserole didn't taste right. Switched back up to 2% and found that it tasted better and if I went up to 100% milk it would taste even better, assuming the tuna folks would stop canning tuna that looks like cat food in their 'chunky' cans.

Even if you get a diet cookbook or one that is for tasty treats for dieters. Every single recipe would call for artificial sweeteners so I can't use them as I'm allergic to artificial sweeteners. I didn't realize it until I had switched to diet Pepsi, and every time at the same time at work (about an hour after drinking it) I would get a headache and no nurse should be working with a headache as it means they can't focus on patient needs. So I stopped that. Then one day I complained of a headache to my son, and he said that is because you are drinking diet Pepsi! I hadn't looked closely on the bottle before bringing it home. So for sure it wasn't all in my head. I wonder how many 'dieters' are wondering why they have headaches and diarrhea (from the mannitol) etc, and don't realize that their 'diet' food is what is causing it.

Eat real food and get some exercise if you can. One of my frustrations is needing to park as close as possible to the front door of businesses as it is so far to walk anymore, but I used to park on the far edges of the parking lot to force me to walk more. I miss being able to go for a walk so very much.