The Cause of Obesity?

[Diane]

Anoop and Max, it certainly is easier to change weight than height (after adulthood has set in, at least..), although it is certainly hard to change weight without concerted effort and enough freed-up hard drive to stay on top of daily behaviour, making the unconsciousness of most behaviour fully conscious, tracking it sufficiently, without either:
a) acquiring OCD in the process,
b) acquiring it's evil twin, anorexia

In order to lose weight and keep it off, one must carefully acknowledge their existence, learn to dance with them, but always lead, never follow.

[zimney3pt]

New York Times article by Tara Parker-Pope "The Fat Trap"

[anoopbal]

I don't think I am equating height to Obesity. The heritability of height is 90%. Obesity is around 70-80% - second only to height. The 10-20% difference probably is a big difference and is hard to give any numbers.

My point is that obesity is a very heritable trait -a lot more than what people give credit to. This thread wouldn't be this long if it were otherwise.

Obesity is measured in BMI. One BMI comes can come to 8-10 lbs. So a few units change in BMI can account a 20-30 lbs. Most people are looking at these 5-10 lbs gains and just extrapolating it to losing 50-100lbs. And more importantly the word 'change' don't say anything about the temporal relation. People can 'change' weight , but to make this 'change' permanent is almost impossible for the majority. I think this could be some of the reasons people have a hard time accepting the fact.

[anoopbal]

Great article Zimney!! I hope more people would read it.

I have the conclusion of the article here. This should sum up our whole discussion very well.

So where does that leave a person who wants to lose a sizable amount of weight? Weight-loss scientists say they believe that once more people understand the genetic and biological challenges of keeping weight off, doctors and patients will approach weight loss more realistically and more compassionately. At the very least, the science may compel people who are already overweight to work harder to make sure they don’t put on additional pounds. Some people, upon learning how hard permanent weight loss can be, may give up entirely and return to overeating. Others may decide to accept themselves at their current weight and try to boost their fitness and overall health rather than changing the number on the scale.

For me, understanding the science of weight loss has helped make sense of my own struggles to lose weight, as well as my mother’s endless cycle of dieting, weight gain and despair. I wish she were still here so I could persuade her to finally forgive herself for her dieting failures. While I do, ultimately, blame myself for allowing my weight to get out of control, it has been somewhat liberating to learn that there are factors other than my character at work when it comes to gaining and losing weight. And even though all the evidence suggests that it’s going to be very, very difficult for me to reduce my weight permanently, I’m surprisingly optimistic. I may not be ready to fight this battle this month or even this year. But at least I know what I’m up against.7

[ian s]

I have just read that 5 minutes ago --strange coincidence . Interesting the idea of brain defending a previous 'normal' state . I also remember ideas from the Blakeslee book on body mapping re altered body image in people who have lost a great deal of weight .....The coach used a lot of proprioceptive cues to help people re integrate their new shape into the brain......
However , I think the primary issue is cultural . A holiday in Paris this Autumn was a very different exeperience to walking down the street in many UK cities . The city is organised around walking and people shop regularly, not fill the car in one go ...Of course there is a lot more smoking and strong coffee too but generally people go for quality not quantity of food .......all you can eat would probably be anathema to the average Parisian?

[Barrett Dorko]

Anoop,

I'd love your opinion of the ad with the Borg Battle Cry on it. Surely you have one.

When you say heritable are you also considering the heritable tendencies toward religion also?

When we no longer equate weight with goodness this conversation may change. For the most part, the culture does not help that at all.

[Barrett Dorko]

This post is in real time. As I sat here across the room at my computer the COTA (morbidly obese) came back from down the street complaining loudly and bitterly about the absence of what she wanted for lunch nearby. "Those people are idiots!" Instead, she was only able to get 8 chicken legs. The rest of the staff supported her conclusions and listened carefully. I, of course, was silent.

How much of that do you think was genetic in nature?

This morning's conversation was about 90% food related and it continues at this moment.

Please just shoot me now.

[zimney3pt]

Please just shoot me now.

Don't do that...they might eat you.

[anoopbal]

Hi Barrett,

Which ad is it?

Yes. The language your speak and the religion you adopt is environment. But how proficient your are in your language or how receptive you are to religion is heritable.

Yes I agree.

[byronselorme]

Hi Anoop,

One thing about mono and dizygotic studies that is overlooked is that no matter what you can never separate the shared environment both twins share in-utero. This is an incredibly formative period that also shares environmental aspects.

[Barrett Dorko]

anoop,

See post #47 on the first page of this thread. I put the picture in just this AM.

I can't agree with that heritable take on either eloquence or religiosity. These are far more culturally influenced than genetically.

I have a twin sister, and we could hardly be more different. For one thing, she moved to South Philly 40 years ago and now sounds like Rocky Balboa. Our mother would be appalled.

[Jon Newman]

Originally Posted by Barrett Dorko

This post is in real time. As I sat here across the room at my computer the COTA (morbidly obese) came back from down the street complaining loudly and bitterly about the absence of what she wanted for lunch nearby. "Those people are idiots!" Instead, she was only able to get 8 chicken legs. The rest of the staff supported her conclusions and listened carefully. I, of course, was silent.

How much of that do you think was genetic in nature?

I don't think Anoop's point is that our culture not only gives us permission to eat in ways that aren't healthy but implores us to. In fact he acknowledges that genetic phenotypes interact with their environment and we're not genetically determined in this regard. His point is that her obesity is largely predicted by her genetics. Even if this person was a recluse and never complained loudly and bitterly about the absence of what she wanted for lunch, or enjoyed conversations about food, her probability of being obese would be higher than someone without her genotype.

I think there is likely a genetic component that has some predictive power as it pertains to your silence versus the rest of the staff's support but it probably isn't quite as strong as a predictor as Anoop's weight example. And not as strong as predicting sociability in C. Elegans

[Barrett Dorko]

Jon,

I agree entirely. It's when numbers start appearing that I grow uneasy.

The behavior of others influences us, of course.

For instance, the worse the staff, the less I speak.

I hardly make a peep here.

I was engaging the speech therapist in some conversation up until today. She came in proselytizing loudly this morning. I'm not kidding.

I guess I'm done talking to her.

[Ben Sabo]

Originally Posted by anoopbal

I think we see have seen some physiological mechanism for muscle memory. The muscle still maintains the myonuclie in the cell which makes it easier to get back. And these comparisons always fail since fat and muscle have way different physiological mechanisms. We now know that fat is an endocrine organ as well.

Is the memory in the muscle, or in the brain? Do the fat cells decide how much leptin to secrete and then determine the sensitivity of the brain to that hormone?

Originally Posted by anoopbal

When you lose weight, there is also a decrease in caloric expenditure which is not proportionate to the loss of body weight. Leptin seems to have an effect on both sides of the equation. And it s pretty much known that exercise do not burn enough calories to compensate for diet. And there has been numerous studies done with diet AND exercise which is marginally more effective than diet alone.

I never said exercise will compensate for diet. But, anyone who tries to lose weight and then maintain that weight loss without exercise (or activity, whatever it is) is probably going to be disappointed.

From the NYT article that Kory posted: "to lose weight and keep it off, a person must eat fewer calories and exercise far more than a person who maintains the same weight naturally. Registry members exercise about an hour or more each day — the average weight-loser puts in the equivalent of a four-mile daily walk, seven days a week. They get on a scale every day in order to keep their weight within a narrow range. They eat breakfast regularly. Most watch less than half as much television as the overall population. They eat the same foods and in the same patterns consistently each day and don’t “cheat” on weekends or holidays. They also appear to eat less than most people, with estimates ranging from 50 to 300 fewer daily calories." ...BINGO! Well, except for the breakfast part, whether you eat breakfast or not is irrelevant. And "eating the same foods in the same patterns" sounds a little rigid. You should enjoy your food!

Here's an interesting article from Science Daily:

Social Interactions Can Alter Gene Expression In Brain, And Vice Versa - "Genes in the brain are malleable, turning on or off in response to internal and external cues... Behavior is not etched in the DNA."

I see genetic determinism as the modern-day replacement for the concept of fate and while I'm certainly interested in the research on obesity, I don't think anything has been "proven" genetically. I just posted an interesting article in another thread, about the vanity of searching for a reductionist "cause" for complex biological processes:

Why Science Is Failing Us - "Causal explanations are oversimplifications."

[Jon Newman]

Originally Posted by Barrett Dorko

I was engaging the speech therapist in some conversation up until today. She came in prosthletizing loudly this morning. I'm not kidding.

What was she proselytizing about?

[Jon Newman]

Originally Posted by Ben Sabo

"Genes in the brain are malleable, turning on or off in response to internal and external cues... Behavior is not etched in the DNA."[/I]

Actually, if people display one behavior when certain genes are turned as opposed to when they're turned off, then behavior is etched in DNA. It's just that the DNA (and its influence on behavior) available to a particular organism can be influenced by internal and external cues.

I'm not arguing that all behavior has this sort of genetic component.

[Diane]

Just saw this on Fbook, and thought it went well with the thread.

[zimney3pt]

Diane, that made me laugh so hard it jarred a memory of one of my favorite clips.

[Diane]

(Good one Kory! And so true!)

One thing that has not yet been discussed is the idea of microbiome. It isn't just our own genes we have to deal with. There's a huge "environmental" influence from inside our own bodies. Well, gut tube to be more precise.

Anyway, this thread has inspired me to write a blogpost, Over the hump, about my own anti-obesity efforts.

[MaxG]

Anoop, I'll ignore the derogatory tone of your past post for the sake of discussion, but would appreciate it, if it didn't occur again.

Originally Posted by anoopbal

It is not MY conclusions based on my biased observations. These are from twin studies which have been done all over the world for decades to study heritability.

If you have a problem with the validity of twin studies, we have a bigger problem here which might shake the whole foundation of how heritability and nature vs nurture is studied.

I don't have a problem with the twin studies. They are highly interesting and one of the new things I learned from your article.
I disagree with the assertion that there aren't possibly different ways to interpret their results.

And try losing 40-50lbs and keeping it off for atleat 3-4 years. That is just 3-4 units in BMI. It probably won't change anything, but will give a different perspective about the word "possible".

I did that actually. In my "adult" life (post 16 years of age) I've fluctuated between 140lbs, up to 245lbs and down to 190-195lbs. This is my current weight and has been so for the past 3 or so years.
I felt not much desire to eat when I was lanky, felt hungry all the time when I was at my "powerlifting weight" and am in the neutral right now.
I enjoy food, but get sick of it when I eat too much.

When I ate more "junk" and had more of it around, I craved it a lot (also all other food as well). This was part of a personal experiment, as I don't usually keep that stuff around and don't particularily enjoy eating it.

Judging by what I've read and my very own experiences, I believe more in a "settling point" not a set point of bodyweight/-fat (to paraphrase Lyle McDonald).

Like was said above, gene expression can be altered, behaviour can be modified.
Some might have a harder time with regulating bodyweight than others, but falling back on genetics as an excuse for obesity is short-sighted, IMO.

Now, as for the dangers of being overweight, or stigmatization of obese people, that is a compeltely different discussion.
I don't care much for the bodyweight of other people and think many health issues attributed to bodyfat might be more due to "bad nutrition" or inactivity (or motor laziness).
I find the stereotypical gluttony that is generally attributed to obese people (rightfully or not) harder to align with my general life philosophy, really.

I've met some impressively athletic and objectively healthy (low blood pressure, heart rate, blood profile) people at over 300lbs of bodyweight. There has to be more to it than just plain bodyfat levels.

Here's some reading material that you might find interesting, re: bodyweight set point:

Set points, settling points, and bodyweight regulation

and Part 2

And this one, about leptin:
note that I've linked to the last part of the series here, so one can find the links to the previous parts, and also because there's the part about leptin regulation in the brain.

Bodyweight Regulation: Leptin Part 6

[Jon Newman]

Hi Max,

You seem committed to the idea that an obese person is obese due solely to personal failing. Correct me if I'm wrong.

Do you have any issues with Anoop's take home messages from his essay?

1. We should focus more on health than weight or the cosmetic aspects.
2. It is clear than moderate weight loss of 10-15 lbs of weight loss in obese people can have dramatic improvements in their health.
3. It is also very clear that eating healthy and exercising has a beneficial effect on health independent of the change in body weight.
4. The major cause for obesity is your genes and not the lack of will power or lifestyle.
5. Obesity is not the fault of obese people. So treat them with respect.

[joebrence9]

Like was said above, gene expression can be altered, behaviour can be modified.
Some might have a harder time with regulating bodyweight than others, but falling back on genetics as an excuse for obesity is short-sighted, IMO.

Agreed.

[MaxG]

Originally Posted by Jon Newman

Hi Max,

You seem committed to the idea that an obese person is obese due solely to personal failing. Correct me if I'm wrong.

No not at all. As I see ir, obese people are usually obese because they follow their appetite (genes, acquired behaviour, social context).
They haven't failed anything really. When an obese person (for whatever reasons) decides to lose weight, has a hard time with it (trying to force the brain out of its habits) and quits, pointing to genetics for his lack of success, then I would point to "lack of willpower" as a factor.
I wouldn't point to "personal failing" really as that carries with it an overly negative connotation, IMO. Faulty planning might be a better term.
Modifying your brains behaviour patterns is harder than just forcing restriction upon it.

Do you have any issues with Anoop's take home messages from his essay?

I agree wholly with 1-3.
I would not agree with point 4. No matter how skewed your leptin regulation, how slow your metabolism, how unfortunate your hormonal profile in regards to fat storage, you don't become obese without the necessary (abundant) food intake.
Mind you, I'm not talking about "a few pounds too many", but seriously overweight.

As for point 5, I tried to clear that up in my last post.
I hold no grudge towards obese people. I may not agree with some of their (stereotypical) lifestyle choices (little activity, mindless food consumption) just as I don't agree with smoker's habit of smoking. I don't look down upon either of them for doing it though.

1. We should focus more on health than weight or the cosmetic aspects.
2. It is clear than moderate weight loss of 10-15 lbs of weight loss in obese people can have dramatic improvements in their health.
3. It is also very clear that eating healthy and exercising has a beneficial effect on health independent of the change in body weight.
4. The major cause for obesity is your genes and not the lack of will power or lifestyle.
5. Obesity is not the fault of obese people. So treat them with respect.

[Jon Newman]

Thanks for the clarification. I agree that an inability to create an environment for success (including faulty planning) foils weight loss and weight loss maintenence attempts. But there are those that don't have the knowledge they need or simply have an inability to control the environment needed for their success. An example might be someone that is mentally retarded and possesses a genetic disposition for weight gain.

Originally Posted by MaxG

When an obese person (for whatever reasons) decides to lose weight, has a hard time with it (trying to force the brain out of its habits) and quits, pointing to genetics for his lack of success, then I would point to "lack of willpower" as a factor.

I wouldn't point to "personal failing" really as that carries with it an overly negative connotation, IMO.

How can I conceive of a "lack of willpower" as not a "personal failure"? Does willpower entail some extrapersonal component?

[Jon Newman]

Here is some advice from Tom Clark. It tackles some of these issues from a particular worldview and has the potential to be discounted due to worldview backfire effect. However, I think the general advice is fairly consistent with what I've seen written about here at SS over time. It's just that the advice is justified differently from how others may explain why they might offer similar advice.

[anoopbal]

Hi Ben,

I have wrote about settling point concept couple of years back in my website. It doesn't change anything. I said people can move can change their body weight plus or minus 15-20lbs and environment can dictate this change.

Honestly, I don't think you have brought anythng to the discussion besides talking about muscle memory and comparing it so smokng. I didn't want to reply to those comments because it s wrong to compare these on many levels. To compare smoking to one of the most fundamental biological drives such eating...

I don't have a problem with the twin studies. They are highly interesting and one of the new things I learned from your article.I disagree with the assertion that there aren't possibly different ways to interpret their results.

You disagree with the studies and have no reasons. But have no problem agreeing with your personal experience when there are hundreds of reasons not to to believe it. The power of anecdotes!

I wouldn't point to "personal failing" really as that carries with it an overly negative connotation, IMO. Faulty planning might be a better term.

Do you know that there cognitive-behavioral approaches (what you call as 'planning') that are studied thousands of times along with dieting but with no avail?

I would not agree with point 4. No matter how skewed your leptin regulation, how slow your metabolism, how unfortunate your hormonal profile in regards to fat storage, you don't become obese without the necessary (abundant) food intake.

Hippocrates told us 2000 years back that it is all about moving more and eating less. Everyone knows that .The question is why are some people doing it more than others in the same environment.

[MaxG]

Originally Posted by Jon Newman

Thanks for the clarification. I agree that an inability to create an environment for success (including faulty planning) foils weight loss and weight loss maintenence attempts. But there are those that don't have the knowledge they need or simply have an inability to control the environment needed for their success. An example might be someone that is mentally retarded and possesses a genetic disposition for weight gain.

Very true. And this person would have a very hard time losing his weight, but is not the norm when it comes to obese persons.

How can I conceive of a "lack of willpower" as not a "personal failure"? Does willpower entail some extrapersonal component?

It's more a matter of wording, I guess.

[MaxG]

Originally Posted by anoopbal

I have wrote about settling point concept couple of years back in my website. It doesn't change anything. I said people can move can change their body weight plus or minus 15-20lbs and environment can dictate this change.

If it works for 20lbs, how does it not work for more? What weight do you take as a set point for saying "plus or minus 15-20lbs"?
If it's the current bodyweight/-fat level of the obese person, how is it not feasible to think if that person lost 20lbs and mainteined that for a while, it would not become his new "set point"?

Honestly, I don't think you have brought anythng to the discussion besides talking about muscle memory and comparing it so smokng. I didn't want to reply to those comments because it s wrong to compare these on many levels. To compare smoking to one of the most fundamental biological drives such eating...

I have not talked about muscle memory at all. If you are referring to my weight fluctuation comment (which you asked for, mind you), my starting weight was about 140lbs. That was before any resistance training had taken place. How is that muscle memory? I would appreciate if you did not put words in my mouth I did not say.

As for the smoking, I am not the one bringing morality into the discussion.
I draw a parallel between two addictive behaviours.
There are no set "fundamental biological drives", even if it sounds very romantic to refer to eating as such.
The big issue with strong addictions IS that they feel just like a "fundamental biological drive" to the sufferers.
I don't see how I should not draw this parallel?

You disagree with the studies and have no reasons. But have no problem agreeing with your personal experience when there are hundreds of reasons not to to believe it. The power of anecdotes!

Again, I don't disagree with the studies.
And if you had seriously considered my arguments, you would not imply I didn't.
I'm merely questioning the implications taken from their results re:heritability.
To put it better, it pretty much just shows that different people have different metabolic settling points at the time the study took place.

Do you know that there cognitive-behavioral approaches (what you call as 'planning') that are studied thousands of times along with dieting but with no avail?

Please refer me to the ones you are talking about. It is hard to comment on this statement without knowing what we are talking about.

Apart from that

Hippocrates told us 2000 years back that it is all about moving more and eating less. Everyone knows that .The question is why are some people doing it more than others in the same environment.

I find it hard to grasp why people have such a hard time with the fact of personal variability.
I thought what behavioral biology has shown decades (many!) ago was that people do not come out of their mother's womb "the same", but are already "imprinted" with many many traits, from genes and from their mother's behavior while in-utero.

Just as people have differing drives to move, have differing intelligence levels, differing bone densities, they of course have differing eating habits from the get-go.

Where it falls apart, IMO, is at assuming that this "pre-determined program" can not be altered by behavioral changes AND councious decisions.

I would dare to assume that not all obese people were born with a disposition to be obese. In the right environment (families' habits, general food availability, types of food, etc) everybody has the potential to become obese. I would also dare to assume, that if tested, this person would show the typical issues of an obese person (e.g. leptin secretion, or lack thereof).

It is unfair sometimes, sure.
But if you wanted to adjust for all heritable differences that could impede someone's personal development you could start by handing out a free college education along with a 100 grand check to every person 18 years of age (normalize financial inequality), also test IQ's of children at varying intervals and personalize their test grades accordingly.

I seriously don't intend to sound derogatory here, excuse me if I did.
I want to repeat again, that I do not intend to make moral judgements about any of these conditions, be they genetic, social or whatever.

I also find obesity research highly interesting as the causation of such personal traits is always worth researching, IMO.
Me questioning certain implications a person could draw out of the results of these experiments does not mean I reject the science, just the way it is laid out here.

[Barrett Dorko]

I remain convinced that the image of the ad is extremely important (post #47 I think).

I'd love some additional comment. As Tony Soprano would say, "It's the 600 pound elephant in the room."

Of course, at some point, elephants are supposed to weigh that much.

[garydiny]

Barrett,

I think that is marketing at its best (worst). Glossy colors, large size, options to add or subtract components. Wording that implies that resisting it is a fruitless endeavor. Marketing to achieve a goal of selling more of them to make money (capitalism at its finest) without the concern for the long-term health/well being of those consuming.

Not sure if that is what you were thinking, but those are my thoughts. Personally it looks very good, tempting, but I would need to be in the mood for it.

Gary

[Jon Newman]

Originally Posted by MaxG

Very true. And this person would have a very hard time losing his weight, but is not the norm when it comes to obese persons.

Well being mentally retarded and having a genetic disposition to weight gain isn't the norm when it comes to obese people, having a very hard time losing weight and keeping it off is the norm when it comes to obese people.

Apparently this willpower stuff has a wide spectrum of existence and specificity to certain sorts of behavior. For example, I think it's fair to say that obese people do have this willpower stuff for other aspects of their life. What's up with that?

[Jon Newman]

Originally Posted by anoopbal

Do you know that there cognitive-behavioral approaches (what you call as 'planning') that are studied thousands of times along with dieting but with no avail?

I didn't know that. Do you have some references? What does "no avail" mean? Is it that they didn't lose the amount they wanted or didn't lose any weight or didn't keep it off?

[MaxG]

Originally Posted by Jon Newman

Well being mentally retarded and having a genetic disposition to weight gain isn't the norm when it comes to obese people, having a very hard time losing weight and keeping it off is the norm when it comes to obese people.

True, actually not only with obese people, simply overweight people as well.
Habits are hard to change.

Apparently this willpower stuff has a wide spectrum of existence and specificity to certain sorts of behavior. For example, I think it's fair to say that obese people do have this willpower stuff for other aspects of their life. What's up with that?

That is an excellent thought. I don't think there's some general "willpower-ability" that is lacking in obese people.
Certainly you'll find highly intelligent, hard working professionals in all fields battling with obesity. They obviously would not have gotten to where they are without drive and a will to sacrifice in certain areas of their life/conciousness.

Some interesting reading:
Willpower

Limited Willpower?

Twopubmed entries I'd be interested in reading in full:

Health Educ Res. 2007 Jun;22(3):397-405. Epub 2006 Sep 13.
Understanding successful behaviour change: the role of intentions, attitudes to the target and motivations and the example of diet.

Ogden J, Karim L, Choudry A, Brown K.
Source

Department of Psychology, University of Surrey, Guildford, Surrey GU2 7XH, UK. J.Ogden@surrey.ac.uk

Abstract

Although many attempts to change health behaviour fail, some individuals do show successful behaviour change. This study assessed the role of behavioural intentions, motivations and attitudes to the target in explaining successful changes in diet with a particular focus on positive and negative intentions and positive and negative attitudes. Participants (n=282) completed a questionnaire describing a recent change in eating behaviour (becoming a vegetarian, cutting out a food group, eating fewer calories), their intentions, their attitudes to the food being avoided, a range of motivations and their degree of success. The results showed that the three behaviour change groups differed in terms of their cognitions with those trying to eat fewer calories reporting less success in changing their behaviour. Successful vegetarianism was associated with a lower positive attitude; successfully cutting out a food group was related to ethical motivations, a lower positive attitude and greater positive and negative intentions, and reducing calorie intake was associated with greater positive intentions and a lower positive attitude. Therefore, success was associated with different cognitions depending upon the type of change being made, although cognitions such as 'I will eat more vegetables' and 'I no longer find high fat foods palatable' were consistently most predictive of success. Suggestions for the development of more effective interventions to change health behaviours are made.

PMID:16971672 [PubMed - indexed for MEDLINE]

Proc Nutr Soc. 2009 May;68(2):205-9. Epub 2009 Feb 26.
The application of psychological theory to nutrition behaviour change.

Barker M, Swift JA.
Source

Food Choice Group, MRC Epidemiology Resource Centre, University of Southampton, Southampton General Hospital, Southampton, UK. meb@mrc.soton.ac.uk

Abstract

Changing individuals' health behaviour seems to be the key to solving many of the world's health problems. Although there is a multitude of potential influences, many interventions to improve health seek to change intrinsic psychological determinants of health behaviour. To date, most attention has been paid to cognitions, such as attitudes and beliefs, and a number of social cognition models (SCM) are in current use. SCM all describe cognitions as determinants of behaviour, thereby implying that changes in cognitions will lead to changes in behaviour. Although SCM are widely used to predict a range of health behaviours, they are associated with a number of important limitations, including poor levels of predictive power, particularly in relation to eating behaviour, and limited guidance about the operationalisation of theoretical constructs. These limitations may explain why very few interventions to change behaviour are explicitly theory-based, despite the widely-held view that having a clear theoretical underpinning will improve effectiveness. Ultimately, advances in understanding and changing health behaviour will come about only if psychological theory and practice are integrated. The recently-published taxonomy of behaviour-change techniques used in interventions is a good example of integrated research, but more work of this type is essential and will require respectful collaboration between researchers and practitioners working from a range of different disciplines such as health psychology, public health nutrition and health promotion.

PMID:19243667 [PubMed - indexed for MEDLINE]

[Diane]

If it's of any use to anyone, a thread on epigenetics. A lot going on with these.

Robert Sapolsky talks about them in his fabulous lecture series, probably #6 and 7. Something about, how your own genes interact with food will be affected by how starved your grandfather might have become, prior to passing his genes on to your mother. Something like that.

If you consider cells as the fundamental unit of life, and the genes as responsive to whatever the surrounds are, of the cell, then you can't help but see the body as just another ecosystem like any other in nature, and all the cells, including all the non-human cells we carry around, as individuals responding to it, trying to make lives within it, competing for resources, adapting, finding ways to try to control it. The human organism is an adapted creature with thrifty (wary, threat-detecting) genes. Some are more like that than others are. All are more biopsychosocial verbs than they are nouns.

[Barrett Dorko]

Gary writes:

I think that is marketing at its best (worst).

Agreed. Shouldn't this amazingly powerful thing be part of the conversation?

[anoopbal]

If it works for 20lbs, how does it not work for more? What weight do you take as a set point for saying "plus or minus 15-20lbs"? If it's the current bodyweight/-fat level of the obese person, how is it not feasible to think if that person lost 20lbs and mainteined that for a while, it would not become his new "set point"?

These are just rough estimates which most researchers would agree.

Your nitpicking about the details about any phenomenon doesn’t magically make the phenomenon disappear. Questions like how does fat cells sense how much fat they have and how precisely the set point are only great questions for future studies.

I have not talked about muscle memory at all. If you are referring to my weight fluctuation comment (which you asked for, mind you), my starting weight was about 140lbs. That was before any resistance training had taken place. How is that muscle memory? I would appreciate if you did not put words in my mouth I did not say .As for the smoking, I am not the one bringing morality into the discussion. I draw a parallel between two addictive behaviours. There are no set "fundamental biological drives", even if it sounds very romantic to refer to eating as such.

I just got you and Ben confused. I am sorry. The most fundamental needs for any living creature can be narrowed down to food, reproduction and maintaining fluid balance. Hence these systems are extremely very well defended in the body.

Do you know that there cognitive-behavioral approaches (what you call as 'planning') that are studied thousands of times along with dieting but with no avail?
Please refer me to the ones you are talking about. It is hard to comment on this statement without knowing what we are talking about.

It is not hard. If you have looked at diets and weight loss, they are widely used. Even the common advice of keeping a journal to record your food patterns (self monitoring) is born from cognitive behavioral strategies. I have even wrote an article about it.

The point is we have studied and tried left and right different strategies. Most people who say thing like ahh it was lack of planning, they took only 550 calories are just not familiar with what is going on in the field.

Again, I don’t see anything in your arguments. You are just looking at the minority and trying to explain for the majority. Exceptions don't change the generality.

If your assertion is true, then obese people lack discipline or cannot change habits and behaviors. There is no other way to slice it even if you are trying hard not to come across that way. If it is true, this will be such shattering discovery worth the Nobel prize in the field of psychology!

[zimney3pt]

Is it that they didn't lose the amount they wanted or didn't lose any weight or didn't keep it off?

Jon, I think you bring up an interesting point.

Most diet plans that people undergo are to get them to a "normal or ideal" weight I would assume (I may be incorrect in this assumption) to be successful. What if a diet plan was set to just lose 10-15 lbs even though a person's ideal or normal weight might be 50-60# less. I wonder what the success rate of those programs might be?

For example a 6' tall male that weighs 250# has a BMI of 33.9 moderately obese(using BMI has many problems, but it is what is most commonly used). If that individual lost 30# they have a BMI of 29.8 to get out of the obesity range. They need to get to 183# to get into normal BMI, that is 67# weight loss. I think the struggle and failure of most diet plans is not in the first 30# but the last 37# in this example. I think the failure to get the last 37# often leads to giving up on the practices that lost them the first 30#.

I wonder if we need to reevaluate to what no avail means when it comes to losing weight?

[Jon Newman]

Hi Max,

I read your links. From the one authored by Greg Walton and Carol Dweck:

You may contend that these results show only that some people just happen to have more willpower — and know that they do. But on the contrary, we found that anyone can be prompted to think that willpower is not so limited. When we had people read statements that reminded them of the power of willpower like, “Sometimes, working on a strenuous mental task can make you feel energized for further challenging activities,” they kept on working and performing well with no sign of depletion. They made half as many mistakes on a difficult cognitive task as people who read statements about limited willpower. In another study, they scored 15 percent better on I.Q. problems.

I'm not sure this is really demonstrating willpower per se. But that's not what I found most interesting. I thought this was interesting because I think this example of how priming people can change behavior (at least for a while) is not so different from the advertisement Barrett keeps referencing.

[ian s]

Diane, that second paragraph was an excellent piece of writing - you should keep it for your book if you haven't already thought of it! There is a piece in the Christmas edition of the BMJ on Evolutionary Medicine - it reminded me of that.
I read somewhere about past generations affecting current health status in terms of epigentics . Perhaps it was studies in the Netherlands on those who suffered under Nazi occupation? http://en.wikipedia.org/wiki/Dutch_famine_of_1944 Obviously the converse of obesity but interesting nevertheless.
Sapolsky is fascinating . In many ways I think we are looking at the middle of the bell curve (the TV ad by Kory) societal forces making the gadgets slim and technologically amazing and the people more like the previous generation of TV's... slower and bigger.
I make strident efforts to have as little to do with mainstream commerical culture as possible--pre cooked family meals etc. There are whole swathes of the population that simply can't cook or wouldn't know what to do with a vegetable...
To be 'well' one needs to move outside the bell curve and study succesful behaviour and be an individual (I am well aware of the links with mental illness and obesity which is a different issue) .
I think all the genetic information is interesting but misses the elephant of the desire to consume more in many facets of life .....It is ironic in a way that for the majority good value is deemed to be based on quantity and grazing but for the rich it is its scarcity value --very small 'dots' of food on very big plates......
Overall the only answer for the majority I believe is to be much less zombie like , be curious about food as its one of lifes pleasures, learn to cook and ignore any person that recommends a particular range of products which aims to make a difference to the waist line......
Oh, enjoy the New Year celebrations with a few highly calorific drams and some good cheese!

[Jon Newman]

Richard Wiseman has some tips (some of which have already been linked to or otherwise discussed) for keeping your resolutions.

How to keep your New Year's Resolutions

[Diane]

Originally Posted by zimney3pt

For example a 6' tall male that weighs 250# has a BMI of 33.9 moderately obese(using BMI has many problems, but it is what is most commonly used)

One thing not yet discussed is how a person's age might factor into all this.

Another thing: the kind of human are we trying to discuss, here, is not a healthy, all-her-life chubby, 85-year-old short female with three grown children and a bunch of grand and great-grand children.

(Ian, thanks.

[Jon Newman]

Maybe the reason we can accept a mentally retarded obese person, or a mentally ill obese person, etc. is because we seem to recognize and accept a limited range of phenotypic plasticity from these individuals but fail to be able to do so with someone else who may have limited phenotypic plasticity themselves, but not in a category accepted by the culture at large.

[caro]

I was watching Cast Away ( http://en.wikipedia.org/wiki/Cast_Away) yesterday and was struck by how much one can glean about eating and weight gain and loss from that film.

Here's some stuff I noted :

-Hanks starts out er, pretty chubby. We see him partaking with several members of his family in a beautiful X-Mas feast. He obviously enjoys food and being around family and friends.

-One of the main drivers behind his determination in ''making fire'', is to be able to cook his food. When he finally reaches his goal, we see him eating crab with great pleasure and satisfaction.

-After the cringe inducing, tooth scene. ( Hanks is forced to extract one of his teeth because of a nasty, nasty abscess. ) There is a fadeout and we see him 4 years later, slender and buff in the process of capturing a fish. We then see him eating the fish dispassionately. He hasn't bothered to cook it.


-Later, when Hanks' character reintegrates society, we see him celebrating with his colleagues. He displays no interest in the splendid buffet laid out for all to enjoy.



-When all is said and done and everyone has left, there is a close-up on the buffet. We see him looking at the crab legs and sushi. Of course, we understand not a bite of this fare has touched his lips.


Although this is a work of fiction, I find its premise quite plausible given how the Hanks character is fleshed-out. I perceived him as highly driven, intelligent and determined. He is still young and generally healthy. I didn't have a problem believing that in this context ( a deserted island ) the movie's protagonist would behave in this fashion.

If you consider cells as the fundamental unit of life, and the genes as responsive to whatever the surrounds are, of the cell, then you can't help but see the body as just another ecosystem like any other in nature, and all the cells, including all the non-human cells we carry around, as individuals responding to it, trying to make lives within it, competing for resources, adapting, finding ways to try to control it. The human organism is an adapted creature with thrifty (wary, threat-detecting) genes. Some are more like that than others are. All are more biopsychosocial verbs than they are nouns.

With regard to Barrett's Star Trek reference (Resistance is futile). :

What's your take on the manner in which food and eating are depicted in sci-fi movies?

[byronselorme]

Originally Posted by Diane

Robert Sapolsky talks about them in his fabulous lecture series, probably #6 and 7. Something about, how your own genes interact with food will be affected by how starved your grandfather might have become, prior to passing his genes on to your mother. Something like that.

Hi Diane, I keep thinking of Sapolsky through this whole discussion. He goes into quite a bit of detail on this topic in "Zebras...." doesn't he?

I was reading through some of my recent lecture notes lately and a public lecture here in Hamilton, Ontario at McMaster University has pegged Hamilton as the fattest city in Canada. We also have a much higher percentage of Mentally challenged people living in the city due to our large amount Psychiatric and Social programs and institutions.

Does anyone see the idea of NeuroElasticity as valuable here? It wasn't that long ago that stroke rehabilitation was deemed useless if someone had paralysis in a limb for more than 2 years. Once Ed Taub started some daunting full time rehab work for an exhausting period of time that time period was changed. Neuroplasticity can work against us as well.

Wouldn't it have been an evolutionary advantage to be able to store food better than your neighbours when high calorie food (up until recently i.e last few hundred years) would have been very hard to come by.

Great discussion so far. With regards to the Ad you mentioned Barrett, I see successful marketing as an outcome of having learned what brain regions respond to what you are using to promote. The smell, sound, and taste of a FastFood restaurant has slowly evolved to hit our targets. The words, colours, and shapes have not been chosen by accident. Otherwise that chain goes out of business. Kind of the natural selection of the calorie movers.

[anoopbal]

Jon, I think you bring up an interesting point.

Most diet plans that people undergo are to get them to a "normal or ideal" weight I would assume (I may be incorrect in this assumption) to be successful. What if a diet plan was set to just lose 10-15 lbs even though a person's ideal or normal weight might be 50-60# less. I wonder what the success rate of those programs might be?

For example a 6' tall male that weighs 250# has a BMI of 33.9 moderately obese(using BMI has many problems, but it is what is most commonly used). If that individual lost 30# they have a BMI of 29.8 to get out of the obesity range. They need to get to 183# to get into normal BMI, that is 67# weight loss. I think the struggle and failure of most diet plans is not in the first 30# but the last 37# in this example. I think the failure to get the last 37# often leads to giving up on the practices that lost them the first 30#.

I wonder if we need to reevaluate to what no avail means when it comes to losing weight?

Excellent question!

I think we can answer this question better if we can finally acknowledge there are things beyond our control and it not about will power.

When studies say success, it is set very conservatively - 10% weight loss in a year. Most programs (diet, exercise, behavior) comes around 8%. The problem is weight maintenance. What is success? It is sure not keeping it off for a year or two. And here is where we are failing. People gain most of the weight back in 3-5 years. And for most severe obese people, this doesn’t even get them below the obese category.

And you are right that most people think of getting back to normal weight as success. Why? It is because the world has convinced that they can and it is a matter of habits, lifestyle and so forth.

Here is an interesting factor. Bariatric surgery people lose 50-60% of the weight and they are only eating around 700-800 calories though almost all of them are obese. Even lean people cannot sustain a 800 cal diet. And they are still not hungry in the same toxic environment. The surgery is somehow rewiring the gut physiology.

[Diane]

Originally Posted by caro

I was watching Cast Away ( http://en.wikipedia.org/wiki/Cast_Away) yesterday and was struck by how much one can glean about eating and weight gain and loss from that film.

What a great bunch of pertinent observation! Yeah.. visible sign his life changed, permanently.

With regard to Barrett's Star Trek reference (Resistance is futile). :

What's your take on the manner in which food and eating are depicted in sci-fi movies?

Everything in the universe is set up to be input-throughput-output at one time or another.
Every atom of our illusory physicality is star dust, same stuff as the planet. And everything else. Really, just atoms bouncing around. We take ourselves so darn seriously don't we?
We're all already dead and we always have been; we just are (temporarily) organized to be slightly steeper-gradiented, slightly more entropy-resistant thermodynamic reactors than other dust that is busy taking a rest.

I don't know about how sci-fi food and eating are depicted - do you have some great examples in mind? Like "You will be assimilated."?

[gollygosh]

A couple of years ago the public broadcasting station recruited several families to live "the pioneer life" I'm not sure of the duration of the project, but one observation that I recall was that the men who were both eating, and performing the chores of mid 1800's men dropped to the weight of mid 1800 men.

Our current lifestyles don't require us to stand up to change the station on a television. Most of us walk to the computer to check our e-mail more frequently than we trek to the mail box. My mother hung clothes on the line for a family of 8--most of my clothes go into the dryer. While none of my siblings is overweight, five out of six of us weigh more than our parents, and when I look at the next generation, there's a lot more flesh on my nieces and nephews than there was on myself and my siblings who grew up in a comfortable 1960's suburban setting. As our lives have become simpler, our food--at least the carbs, fats, and proteins are abundantly available. We seem to be victims of our advances.

I am curious if the of micro-nutrients which are decreased in a processed food diet some how keep the the hunger signal from being produced.

Geralyn

[Ben Sabo]

Originally Posted by Jon Newman

Actually, if people display one behavior when certain genes are turned as opposed to when they're turned off, then behavior is etched in DNA. It's just that the DNA (and its influence on behavior) available to a particular organism can be influenced by internal and external cues.

I'm not arguing that all behavior has this sort of genetic component.

Hi Jon,

So, how do we know which came first? Did the internal/external cue switch the gene on, or did the activated gene determine which cue the individual would be more likely to respond to? Is there any way to know for sure? This is a sincere question, btw, and I think it embodies the issue I have with the argument Anoop's scientists have made.


Anoop,

the muscle "memory" example is not irrelevant, IMO. Whether an individual loses fat or muscle by changing their behavior, they will not recover those losses unless they resume their previous behavior. My simple question, which you didn't really answer, is if one case is an expression of a gene (behavior leading to regaining fat) and one is not (regaining muscle). And if not, why not? Stating that they are different physiological processes doesn't answer the question. Your brain (not your body) will "defend" against fat loss whether you are obese or not, even if you are literally starving to death. I guess that must be coded in the genome, but I fail to see how that is specific to obese individuals.

Originally Posted by Barrett Dorko

Agreed. Shouldn't this amazingly powerful thing be part of the conversation?

In a way, I think it has been. To me, that NYT times article is conveying the same message as the image you posted in #47. "There's no point in fighting it. You can't win. We'll even give you a 'scientific' reason to give up and give in." The cynic in me questions whether Tara Parker-Pope even wrote that article.

[Diane]

God of Cake, from Hyperbole and a half.

It brilliantly depicts the way the frontal lobes have to be firm parents and outwit the demands of the non-conscious brain (habit), inner environment (screwed up physiology/microbiota), and outer environment (lifestyle) for treats&sweets (or carbs, or alcohol, or..), or else be outwitted by them.

[Jon Newman]

I imagine Chuck Noland would have gained a fair amount of weight back as the years went on although is desire for seafood may not so much.

Although not the same as being isolated on a deserted island, being in the Peace Corps is often a significant sustained cultural change for most volunteers. Lots of volunteers either lost or gained weight. Upon return to the US most volunteers comment on how going to a grocery store and a variety of other cultural experiences are off putting. However, most acclimate as they had prior to going. I suspect most experience weight changes again.

Perhaps creating the environment necessary for the desired phenotypic change is so energy demanding or so thwarting of other desires that it simply isn't a sustainable process for many people.