Critiquing Gary Taubes, Part 2: Atkins Redux

by ChrisHallquist4 min read30th Dec 2013191 comments

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Previously: Mainstream Nutrition Science on Obesity

Edit: In retrospect, I think it maybe should have combined this post with part 3. Unfortunately, the problem of what to do with existing comments makes that hard to fix now.

Taubes first made a name for himself as a low-carb advocate in 2002 with a New York Times article titled "What if It's All Been a Big Fat Lie?" When I first read this article, I was getting extremely suspicious by the second paragraph (emphasis added):

If the members of the American medical establishment were to have a collective find-yourself-standing-naked-in-Times-Square-type nightmare, this might be it. They spend 30 years ridiculing Robert Atkins, author of the phenomenally-best-selling ''Dr. Atkins' Diet Revolution'' and ''Dr. Atkins' New Diet Revolution,'' accusing the Manhattan doctor of quackery and fraud, only to discover that the unrepentant Atkins was right all along. Or maybe it's this: they find that their very own dietary recommendations -- eat less fat and more carbohydrates -- are the cause of the rampaging epidemic of obesity in America. Or, just possibly this: they find out both of the above are true.

When Atkins first published his ''Diet Revolution'' in 1972, Americans were just coming to terms with the proposition that fat -- particularly the saturated fat of meat and dairy products -- was the primary nutritional evil in the American diet. Atkins managed to sell millions of copies of a book promising that we would lose weight eating steak, eggs and butter to our heart's desire, because it was the carbohydrates, the pasta, rice, bagels and sugar, that caused obesity and even heart disease. Fat, he said, was harmless.

Atkins allowed his readers to eat ''truly luxurious foods without limit,'' as he put it, ''lobster with butter sauce, steak with béarnaise sauce . . . bacon cheeseburgers,'' but allowed no starches or refined carbohydrates, which means no sugars or anything made from flour. Atkins banned even fruit juices, and permitted only a modicum of vegetables, although the latter were negotiable as the diet progressed.

It's one thing to claim that, all else equal, low-carb diets have advantages over low-fat diets. It's another thing to claim you can eat unlimited amounts of fatty foods without gaining weight.

I'd heard of Atkins before but didn't know much about him. I got curious to know more about the man Taubes was casting as the hero who just may have been "right all along," so I popped over to the Wikipedia article on the diet, which says:

Many people believe that the Atkins Diet promotes eating unlimited amounts of fatty meats and cheeses. This was allowed and promoted in early editions of the book. In the newest revision, not written by the now deceased Dr. Atkins, this is not promoted. The Atkins Diet does not impose caloric restriction, or definite limits on proteins, with Atkins saying in his book that this plan is "not a license to gorge," but rather that eating protein until satiated is promoted. The director of research and education for Atkins Nutritionals, Collette Heimowitz, has said, "The media and opponents of Atkins often sensationalise and simplify the diet as the all-the-steak-you-can-eat diet. This has never been true". However, this new approach by Atkins Nutritionals is often at odds with the earlier writings of Dr. Atkins.

The last sentence of this paragraph is helpfully marked "citation needed," leaving an unresolved conflict between whatever Wikipedia editor wrote the paragraph and what the Atkins folks (at least now) claim. I ordered a used copy of the original 1972 edition of Atkins' book through Amazon, and what I found supports the Wikipedia editor. The folks currently in charge of Atkins Nutritionals are white-washing.

The sensational "truly luxurious food without limit" quote in Taubes' article, for example, can be found on page 15 and comes with no context that would make it more reasonable. In fact, lest anyone misunderstand it, it's followed by a statement that "As long as you don't take in carbohydrates, you can eat any amount of this 'fattening' food and it won't put a single ounce of fat on you." (In the book, this is italicized for emphasis.)

Atkins acknowledged that most of the people who used his diet ended up eating less overall, but claimed that some of his patients had lost significant amounts of weight eating 3,000 calories per day or more. In one case, Atkins claimed, a man had lost fifty pounds on a diet of 5,000 calories per day. He attempted to explain this by invoking the fact that extremely low-carbohydrate diets will cause people to excrete ketones (which Atkins referred to as "incompletely burned calories") in their urine. However, as a statement on the Atkins diet put out by the American Medical Association explains:

When ketone excretion incident to such diets has actually been measured, it has been found to range between 0.5 and 10 gm/24 hr. Studies carried out on starving nondieabetic persons indicate that at most about 20 gm of ketones per day may be excreted in the urine. And, as Folin and Denis have show, the total acetone excretion with the breath is quantitatively insignificant; at most, 1 gm/day. Since caloric value of Ketones is about 4.5 kcal/gm, it is clear that, in subjects on ketogenic diets, ketone losses in the urine rarely, if ever, exceed 100 kcal/day, a quantity that could not possibly account for the dramatic results claimed for such diets.

As far as I can tell, nobody today defends Atkins' original "ketones in the urine" explanation for how his diet supposedly works. It's not entirely clear to me what was going on with the patients Atkins claimed lost weight on a high-calorie diet, but it wouldn't be surprising if a minority of his patients had simply misjudged their caloric intake. In spite of this, Taubes still appears to want to defend Atkins' most extreme claims about people being able to eat unlimited fat without gaining weight.

This isn't entirely obvious when you read his books Good Calories, Bad Calories or Why We Get Fat, which go for a slightly less sensational presentation than the Times article. Nevertheless, in the epilogue to Good Calories, Bad Calories, he claims that "Dietary fat, whether saturated or not, is not a cause of obesity, heart disease, or any other chronic disease of civilization." There's a sense in which that claim might be somewhat plausible, if he meant that it's total calories, not fat per se, that's the main culprit in all those problems. But Taubes also puts a lot of energy (no pun intended) into attacking the mainstream emphasis on calories. 

Why We Get Fat, for example, contains claims such as:

[A 1965 New York Times article claimed that] "It is a medical fact that no dieter can lose weight unless he cuts down on excess calories, either by taking in fewer of them, or by burning them up." We now know that this is not a medical fact, but the nutritionists didn't in 1965, and most of them still don't. (p. 161)

But we know now what happens when we restrict carbohydrates, and why this leads to weight loss and particularly fat loss, independent of the calories we consume from dietary fat and protein... If you restrict only carbohydrates, you can always eat more protein and fat if you feel the urge, since they have no effect on fat accumulation. (p. 174)

No effect? That's a strong claim. And as we'll see in the next two posts, Taubes' evidence for this claim ends up consisting largely on a series of misrepresentations of mainstream nutrition science, which allow him to present his views as the only alternative once he's knocked down his straw men.

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Playing gotcha with with quotes that don't hedge enough on extreme cases of caloric intake doesn't seem like the best way to go about this. Maybe concentrate the critique a little more?

Taubes would agree that someone who is overweight necessarily has consumed more calories than they have burned. He's said so in maybe every interview I've ever heard with him. His claim is that that is epiphenomenal to a metabolic condition that prevents people from using fat as an energy source, which is in turn caused by excess carbohydrate intake.

Is there good reason to think he is wrong about that? Or does mainstream nutrition science agree with that view-- despite what they've recommended to people for the last 30 years?

Playing gotcha with with quotes

Perhaps part of the problem is that it's not 100% clear what Taubes' position is. It's arguably in his financial interest to leave his position ambiguous. There is huge marketing value in giving people permission to pig out; at the same time it's easier to defend his position if he doesn't approve of pigging out.

5Jack7yHis position seems plenty clear to me as far as anyone's position is clear: Obesity isn't about pigging out, it's about consuming refined carbohydrates.
4brazil847y(I've gotta say, the word "about" has always peeved me whenever people claim that "X is about Y." Ever since I was in college and I heard feminists asserting that "rape is about power not about sex." ) But anyway, you seem to be saying that, according to Taubes, if you simply avoid eating refined carbohydrates, you can eat other foods ad libitum and avoid obesity. Is that pretty much it? Also, could you define the phrase "refined carbohydrates" for me?
-2Jack7yYes. No. There are adequate definitions that are easily googleable. And precisely how I might disagree with those definitions isn't important since you and I aren't going to have an extended conversation about this. If you're curious you can read the discussion I'll have with Chris.
2brazil847yIf that's the case, then it's odd you wouldn't simply take a few seconds to Google, cut, paste, and link your definition. Your choice seems to support my hypothesis that Taubes' position is unclear. If you choose not to back up your claim that Taubes' position is "plenty clear," I will choose to draw my own conclusions. Your choice and my choice.
-5Jack7y
-3brazil847yThis is just a bookmark post, no need to respond.
6[anonymous]7yI really like this fragment.
3ChrisHallquist7yJack, This is looking ahead two posts into my plans for the series, but it seems to me that Taubes' position on calories ends up not even being coherent. This idea of calorie intake and expenditure being an epiphenomenon... Taubes certainly does say things that seem to suggest that, but what it would even mean for that to be true? If you could explain in a little more detail what you think Taubes is trying to say here, I'd appreciate it. But I've re-read the relevant sections of Taubes' books several times, and I can't see a charitable way to interpret it.

Yeah, I was trying not to pull you ahead. But dealing with the big picture is more my style.

Taubes certainly does say things that seem to suggest that, but what it would even mean for that to be true?

I think he says it pretty directly actually. Good Calories, Bad Calories:

When Rony discussed positive energy balance, he compared the situation with what happens in growing children. “The caloric balance is known to be positive in growing children,” he observed. But children do not grow because they eat voraciously; rather, they eat voraciously because they are growing. They require the excess calories to satisfy the requirements of growth; the result is positive energy balance. The growth is induced by hormones and, in particular, by growth hormone. This is the same path of cause and effect that would be taken by anyone who is driven to put on fat by a metabolic or hormonal disorder. The disorder will cause the excess growth—horizontal, in effect, rather than vertical. For every calorie stored as fat or lean tissue, the body will require that an extra calorie either be consumed or conserved. As a result, anyone driven to put on fat by such a metabolic or hormonal defect would be

... (read more)
-2ChrisHallquist7yTaken literally, this is false. Children voraciously isn't literally an epiphenomenon of their growth. If it were, children would still grow regardless of how little they eat. But in fact, not eating enough when you're a kid stunts your growth. Of course, one way to defend Taubes here is to assume a lot of his rhetoric isn't meant to be taken literally. But the farther you go in that direction, the less he ends up disagreeing with mainstream nutrition, and the harder it is to make sense of the things he says about how awful mainstream nutrition science is supposed to be.
6Vaniver7yWhere did "epiphenomenon" come from? I think you're interpreting him far too uncharitably; he's not saying "how much a child eats has no impact on their growth," and indeed he's saying the opposite. He's saying that the causal chain starts with the growth hormone, which influences how much they eat, and then the hormone and how much they eat influence how much taller they grow. (And he's unclear in the first sentence, but I'm pretty sure he does mean taller, not just larger.)
8ChrisHallquist7yIt was Jack who first used the word "epiphenomenal" upthread.
5Vaniver7ySo it is; I agree with you that epiphenomenon is not a sensible description of the impact of eating on growth, and I disagree with Jack; I don't think that's a good description of Taubes's passage there.
5Jack7yIt is literally true. Notice the tense. It's not an effect of their growth it's an effect of their being something that is growing -- having a hormonal system that is aligned toward increasing size.
1hyporational7yAre you saying that children would grow eating nothing? If not, what's with the word games? Cells won't grow from nothing unless they're made of nothing.
-6ChrisHallquist7y
9RichardKennaway7y"Epiphenomenon" is somewhat hyperbolic, but it does make a sensible claim. To make clear what that claim is, it is necessary to think about causal graphs, because intervention in a system to produce a desired result can only be successful if it is based on a correct understanding of how the system works. "dW/dt = Calories in - calories out", while literally true, carries with it the suggestion that a sufficiently accurate causal graph for this problem is one with two arrows, from input to weight and from output to weight. All you have to do to lose weight is to eat less and/or exercise more. If the causal model is correct, the predicted result of an intervention will happen. If the predicted result does not happen, the model is wrong. It seems to be more often the experience than not, that the predicted result does not happen. This brings the model into question. Causal models make two sorts of claim: the claims that are seen, and the claims that are not seen. The claims that are seen are the variables and the arrows of the model: they claim that these properties of the world exist, and these causal influences exist among them. The claims that are not seen are the absences of variables and arrows. Where there is no arrow, the model claims that there is no direct causal effect. Where there is no variable, the model claims there is no other phenomenon in the world causally relevant to the things being modelled. To repeat in the face of the failed prediction, "but...input minus output!" is to attend only to the claim that is seen. One of the claims that is not seen in this model is the absence of an arrow from input to output. Suppose we hypothetically add one: suppose that restricting calorie intake makes the body reduce its expenditure also. (Or in concrete terms: skip eating for a day and collapse with exhaustion.) What is now the effect on weight of eating less? That depends on the details and relative magnitudes of how these things influence each other. That
9DanArmak7yI haven't read Taubes' books, but I have read some of his blog posts and here's how I understand this position. I'm not very certain that my understanding is correct, but maybe this will help. He agrees the "simple thermodynamic" calories in - calories out = weight gain model is (necessarily) true. But he thinks it's misleading and isn't helpful, because it focuses on the (high) calories in and (low) calories out as the causes of weight gain, as if they were solely and directly influenced by deliberate behavioral choice. He says they are proximate, not ultimate causes, and are mostly determined by various complex metabolic states. And these states are in turn influenced, among other things, by the makeup of the diet - rather than just by its caloric value. So if not conscious behavior, what determines calories in and out? For instance, various metabolic and hormonal states determine the level of hunger, food cravings, etc. What his epiphenomenal claim means, if true, is that the causal graph doesn't look like this: Decide what and how much to eat => Eat as decided => Lose or gain weight But like this: Eat something => Metabolic state changes depending on diet => Hunger levels and specific cravings change in response to metabolic state => Eating behavior changes in response to hunger. And in particular: Eat refined carbs => hunger levels rise, more food cravings => end up eating more => weight gain, sometimes in a runaway positive feedback loop leading to obesity. On his blog he goes into a lot of detail about the biochemistry of hormonal signals relating to hunger, and to fat storage and release; I can't really follow those discussions.
3ChrisHallquist7yThe problem is that nobody in mainstream nutrition science actually thinks that.
3Randy_M7yI think in general mainstream diet advice, by the time it is filtered down to nurses comments and PSA's, ends up being on the order of "choose to eat less food and burn more calories through exercise" and virtually none of "did you know that what you eat can determine how hungry you are?"
-3Eugine_Nier7yActually, a lot of people do. They might not be the "nutritional experts", but it is a common enough position (here [http://lesswrong.com/lw/je4/critiquing_gary_taubes_part_2_atkins_redux/a8qv] for example) that it needs to be addressed.
5ChrisHallquist7ySure it's worth addressing. But in a way that doesn't imply it's what the experts think, which Taubes does.
5hyporational7yThat linked comment doesn't actually seem to say what you think it says.
2hyporational7yLooks reasonable. Are you sure you're not steelmanning his position?
5DanArmak7yI'm giving my best understanding of his position. And I didn't read his book, only some (admittedly very detailed and technical) blog posts. So I might well be filling in some gaps and misremembering what exactly he wrote. But that's useful too surely - if the evidence he presents in his book and elsewhere works as evidence for this steelmanned argument.
0Randy_M7yI think he may be clarifying or simplfying his position, but this is the same impression I have from sources that reference Taubes, such as the movie Fathead.
4jimrandomh7yCalorie intake and expenditure are automatically regulated by the body, and in a healthy person, marginal increases or decreases in calorie intake will cause matching changes to both appetite and to energy expenditure, by changing body temperature, fidgeting, and other expendable metabolic processes. Large, forced decreases in calorie intake must cause either a balancing release of energy from fat cells, or a matching reduction in energy expenditure, but unfortunately, it's likely to be the latter. In that case, the energy expenditure comes from sacrificing metabolic processes that aren't really expendable, damaging health. Obesity can only occur if this regulatory process is broken somehow. It is more likely to be broken by a high-carbohydrate diet than by a high-fat diet. If it's broken in someone who's on a low-fat, high-carbohydrate diet, then switching to a high-fat low-carbohydrate diet is likely to fix it. The previous paragraph is what I believe to be true. I don't know how well it lines up with what Taubes has said, but I don't care because Taubes is just a human. It does seem that he's failed to communicate it clearly, but if you're going to criticize him for that, the criticism should be delivered in the context of a clear restatement of the same position. If you're going to go around saying things that are incompatible with the previous, then please address it directly; everything you've said so far is at least one step removed, and it's frustrating because you keep saying things that aren't even wrong.
0hyporational7yRETRACTED: THIS WAS BS. Are you saying that at no point of our evolution did our ancestors benefit from gaining a little storage fat in a way that we inherited, and even if they did, the only way to use those stores would be damaging?
5Randy_M7yConsider that the need for extra fat storage may often be seasonally based. Our bodies could sense upcomnig times of scarcity based on temperature, sunlight, and the types of food available (different fruits or vegetables ripe, etc.) All of these cues are of course scrambled to various extents in our (understandable) drive for optimal comfort at any time.
2[anonymous]7y[googles for obesity air conditioning]
2hyporational7yGoogle for sauna for obesity while you're at it. And sauna belt, if you want to go real extreme.
0Douglas_Knight7yWhat markdown code produced that comment?
3[anonymous]7yBackslashes to escape the square brackets, and backticks to produce the monospaced font.
2Douglas_Knight7ythanks [it isn't necessary to escape brackets]
0drethelin7yAir Conditioning causes Obesity
0Randy_M7yI'm not sure whether that is a reductio ad absurdium refutation or support.
0hyporational7yThose are good points, and I think there probably has been a conscious component in such behaviour too in later ancestors, and these same cues might affect hunger just as well as metabolism.
0jimrandomh7yNo, I'm not saying that.
2hyporational7ySorry about the strawman. I should have just asked you some questions. Why would evolution have applied strong braking mechanisms to the accumulation of fat? It seems I misunderstood this too. Can you taboo large and forced?
2NancyLebovitz7yPeople and other animals have satiation for food.
0hyporational7yIt sure slows down fat accumulation but has other functions too, like not getting so full you're not able do anything else than digest food. Also there are plausible reasons why you would eat past satiation. Satiation is not necessarily the same thing as not getting pleasure from eating excess food, especially if you live in an environment where food could become temporarily scarce. I also talked about satiation here [http://lesswrong.com/lw/jdw/critiquing_gary_taubes_part_1_mainstream/a8ze], and don't find attacking this issue just from a single angle at once useful.
1Ishaan7yIf humans evolved under conditions where there was usually a calorie surplus available, then humans wouldn't have evolved in such a way that it would just keep storing fat for as long as it could. So 1) were our foraging ancestors chronically malnourished? (I think no) 2) are there any individuals who don't store additional fat despite eating as much as they want? (I think yes and I think I am one) There's satiety, there's increases in energy expenditure, there's allocation of excess energy into lean body mass, etc. There's lots of stuff the body might potentially do with extra energy other than throw it away or turn it into fat.
3hyporational7yWrong question. Would there have been several times when stored fat could have been useful? You think all the millions of years were smooth sailing? How much can you eat in calories without getting fat? Have you tried eating say 5000kcal a day without exercise? I could have probably eaten that much as a teenager but I also exercised a lot back then. Now I can eat maybe 2000-2500kcal without getting fat. Muscle is much easier to gain too now. There definitely are individuals who can eat pretty safely as much as they want, and most of them are young.
0Ishaan7yOf course not, but to the extent that such an experiment would be revealing: an individual named Sam Feltham reportedly did try a similar stunt - 5000kcal of low-carb-high-fat diet for 21 days - without gaining much weight. He didn't stop the exercise he was already doing, but he did account for the exercise in his caloric expenditure calculations. If we trust his honesty, then it's safe to say that at some individuals exists who don't gain weight in response to eating a lot of some calorie sources.
7NancyLebovitz7yOverview of overfeeding experiments in humans [http://archive.unu.edu/unupress/food2/UID08E/UID08E05.HTM]
0hyporational7yThanks. I'll have to take a good look at that.
2NancyLebovitz7yThanks. If it's at all complete, I'm shocked at little research there was.
0hyporational7yYou'd be surprised how many of my Medline searches on specific issues that should be simple to research return nothing. Maybe I just suck at searching. Also, much of the research on "established facts" is so old it's difficult to access electronically.
2hyporational7yIt's not exactly a stunt. I've seen several people who eat much as 10000 kcal a day, all of them severely obese. Of course, they're not on a low carb diet, but eating 5000 kcal is a breeze if you put your mind to it. I could do it easily if I wanted to too. I totally believe he did that and didn't gain weight, but that might not tell us much about people in general.
2[anonymous]7yIt's not like evolution magically stopped when agriculture was introduced, and early farmers were chronically malnourished. (It has had less time to operate since then than before then, though.)
1Douglas_Knight7yYes, but is it less coherent than the mainstream? Or even than a typical nutritionist that claims to be mainstream?

All of these posts seem much more appropriate for the Discussion section.

Warning - for reasons that I haven't quite understood, talking about diet can be almost as bad as politics in its potential for controversy and mind-killing.

5ChrisHallquist7yThank you. I am now learning that the hard way :(
3NancyLebovitz7yHypothesis: For reasons which are not entirely clear to me, not being fat has become evidence of virtue, health, status, and sexual attractiveness. At the same time, there is no known reliable method of stably enabling the majority of people who are fat to cease to be fat.
4Ishaan7yPrediction which follows from that hypothesis: People should be similarly worked up about exercise? (High intensity vs. low intensity, aerobic/anaerobic ratio, etc). I don't run into nearly as many people with strong opinions about this topic, so I think that this can't be the only factor at play... Fascinatingly, diet is not on wikipedia's list of controversial topics [http://en.wikipedia.org/wiki/Wikipedia:List_of_controversial_issues] EDIT: nm, corrected by /u/Nornagest here [http://lesswrong.com/lw/je4/critiquing_gary_taubes_part_2_atkins_redux/a9yf] But I think that you're right, and the reason people aren't concerned about exercise is that fewer people exercise. Everybody eats, and so a large number of mildly-nerdy-people have done at least a little research on diet, formed an opinion, and (to some extent) base their diet around that opinion. It's one of the few scientific topics that laypeople are deeply interested in, and one of the few topics that can make media headlines....and perhaps exercise makes fewer headlines because the market is smaller and thus it's harder to profit from it. I think there's other driving factors too - why does the topic of vaccination enjoy similar polarization in some circles? Why the large number of people worried about GMO, pesticides, water fluoridation, drugs, etc? I think putting things into your body somehow inherently ties into our "purity" sense...thinking about threats to human bodily integrity instinctively sets off strong emotions. However, at least many of those topics have some public policy ramifications, while the impact of the the carb vs. fat debates on public policy is limited. ...and that's before you consider the whole problem of using conscious animals and of environmental impact, which I'm sure creates a negative halo effect by giving a few individuals instrumental incentives to believe that certain diets are bad for human health in addition to being bad for the environment / hurtful to animals. (Though
4Nornagest7yBut obesity, nutrition, and, interestingly, high-fructose corn syrup all are.
2Ishaan7ythanks, parent edited
2NancyLebovitz7yYou may be on to something with the "putting things into your body" theory, though I think another piece is that fat% has a fairly clear effect on appearance, while people can be quite athletic [https://www.google.com/search?q=fat+triathlete&espv=210&es_sm=93&source=lnms&tbm=isch&sa=X&ei=U4rBUp_iDcWvsQSM24G4DQ&sqi=2&ved=0CAcQ_AUoAQ&biw=1366&bih=666] without showing it. There may also be accidental historical factors which can't be derived from grand theories. How combative people are about religion varies a lot by time and place. For that matter, nutrition is a much hotter topic now than it was mere decades ago.
0[anonymous]7yPeople who are fat and sedentary don't look quite like that (e.g. worse posture).
0NancyLebovitz7yI believe you, and I should have been more exact. From what I've read, most people can't tell the difference by looking between a fat person who exercises and a fat person who doesn't.
2brazil847yI believe Steve Sailer hypothesized that every controversial issue has at least one unpleasant truth which people are subconsciously aware of (or afraid of) but reluctant to face. This, according to the hypothesis, generates the cognitive dissonance which generates the mind-killing emotion. In these discussions of diet and obesity, I wonder what percentage of the participants are obese/overweight and troubled by their obesity/overweight.
5fubarobfusco7yBoth sides of a controversy may assert that they are in possession of an "unpleasant truth" that the other side is afraid to admit to. Conspiracy theories work pretty well as "unpleasant truths", for instance; as do prejudices, eschatological or afterlife beliefs, and so on. So that doesn't seem to be a good guide to who is correct when you're within the controversy.
0brazil847yI agree 100%. And in fact (well at least in my opinion) there are basically no shortcuts to determining who is correct. Because once a shortcut is announced, the fellow who is in the wrong will attempt to twist things to make the shortcut appear to favor him. Nevertheless, Sailer's theory may be correct.
2Ishaan7yTwo separate points: 1) As a heuristic, that seems like rhetoric designed to create a bias towards certain viewpoints , not rationality. In every controversy there are two sides that believe different things, and often at least one side often believes that the other is missing some sort of "uncomfortable truth" which collapses their worldview. There's no a-priori reason to assume uncomfortable-truth-proposers are the correct ones in a given controversy. 2) There may or may not be be "uncomfortable truths" around obesity relating to its relationship to willpower, etc. However, that's not sufficient to explain why talking about the fine points of high fat vs. high carb diets should ignite controversy. If the title of this post was "Obese are fat due to X moral failure", I'd understand the controversy, but the outcome of the carb vs. fat debate won't negatively impact any demographic, except for various business interests and concerns about animal rights or environmentalism. (And that doesn't really seem to be the debate driver either) How do people's identities get tangled up with a carb vs. fat position, and the question of whether or not a high-fat-low-carb diet allows for a higher caloric consumption without gaining more weight? At the face of it, the question seems specific and non-threatening - no threat of moral failure, no criticism... only the possibility that some people might benefit by changing their diet composition.
0brazil847yPutting aside whether it's a useful heuristic or not, one can ask if it is in fact true. Put another way, why is it that some disputes excite a lot more emotion than others. Next, if Sailer's hypothesis is correct, one can then ask if his observation can be used as a heuristic to figure out which side is more likely to be correct. As I pointed out in another post, I think the answer is "No." I think that in general, there are no proxies to figuring out which side of a controversy is correct. Because proxies are vulnerable to munchkinism. I'm not sure about that; my impression is that a lot of people -- including fat people -- have a lot invested emotionally in their views on which diets are effective and which aren't. If someone (1) is fat; and (2) has beliefs about which diets are effective, it seems that there would be a lot of opportunity for cognitive dissonance.
0Ishaan7yI think the answer is "yes", so let's clarify what we mean: I read the phrase as "unpleasant propositions which are commonly debated are likely to be true" There are debates where one side is arguing for a belief which both sides find unpleasant. Sailer's hypothesis implies that any commonly debated proposition which is less pleasant than its alternative explanations is more likely to be true. -------------------------------------------------------------------------------- Explaining it a different way: Blue: X is a more pleasant belief than not-X. Also, X is true. Green: X is a more pleasant belief than not-X. However, X is false. not-X is the only possible candidate for an "unpleasant truth" , so wouldn't Sailer's hypothesis elevate the priors for X being false? The implicit rational here for the Sailer's hypothesis would presumably be, "no one wants to believe not-X and therefore everyone is systematically biased towards X. Thus, the existence of individuals who believe not-X elevates the prior for not-X proportionately more than the existence of individuals who believed X. So, all else being equal, favor the unpleasant hypothesis." The hypothesis is essentially modeled off the logic of how a negative result for a test which has a tendency towards false positives is more informative than getting a positive result for the same.
0brazil847yI didn't read it that way. And looking at what issues excite a lot of emotion, it appears to me that frequently the real trigger is related only indirectly. That may be so, but it's not so easy to assess unpleasantness. For example, if you talk to some survivalists you get the impression that they WANT there to be a societal breakdown even though it would mean millions of people dying horribly of famine, disease etc. Besides, I think a lot of disingenuous people are smart enough to say something like "I wish my position were untrue" or "I have no dog in this fight" in order to enhance their credibility.
0Ishaan7yWell, presumably because it would prove them right all along, not because they enjoy chaos...but it doesn't hold any explanatory power to say that people feel strong emotions towards certain epistemic questions because certain beliefs are more or less pleasant, and then to turn around and say that the reason a belief is (un)pleasant is that it affirms/contradicts a previously held belief. That's circular. The initial idea of saying that there is an "unpleasant truth" in every controversy was to create a theory that had predictive power over which issues people would get emotional over. If we then say that unpleasant truths are those which prove people wrong, we lose predictive power - in LW terms, our theory stops paying rent. We'd be better off just saying "people don't like changing their minds" in general, if we're not going to predict which issues and which conditions will create this sort of emotional stubbornness. I think it's important to create a distinction between the satisfaction of having one's beliefs confirmed vs. actually wishing certain beliefs to be true. They are both sources of bias and mind-kill, but they are very different. The survivalists are presumably feeling satisfaction for the former reason (vindication) when faced with talk of society collapsing, even as they do not feel the latter (true preference for a universe where society collapses).
2brazil847yI'm not so sure about that. Once, after a few drinks, I directly confronted a survivalist about this issue. He basically told me that due to his working class background, he felt locked out of the elite; that if there were a societal breakdown he would have the opportunity to become a high status person. I would guess that a lot of survivalists have feelings along these lines; that they resent modern society's power structure and that at some level they wish it would fall apart. But anyway, I agree you have articulated a problem with Sailer's hypothesis. You can always find an "unpleasant truth," particularly if you read "unpleasant truth" to include situations where peoples' long-held beliefs are wrong. Regardless of whether the underlying beliefs are pleasant or unpleasant. I'm not sure if that's the idea, but regardless of whether or not that was the aim, I certainly agree that if the hypothesis lacks predictive power then there's a good chance it's worthless. One can put things a slightly different way: How do you know if people are facing evidence of an uncomfortable truth apart from them getting emotional about it? Putting aside my question about survivalists' preferences, why draw the distinction? Ultimately the effect is the same, no?
1Ishaan7yI don't think so. To continue the survivalist example - a survivalist who wanted the belief that civilization would collapse to be true would be making villainous plots to cause the collapse. A survivalist who simply wanted to be vindicated but didn't actually desire collapse would look at the first signs of collapse, tell everyone "I told you so" with a rather smug expression, and then join them in the fight to prevent civilization from collapsing. Being emotional is probably not a good signal of this. For example, plenty of atheists are emotional about religion - that doesn't mean they are uncomfortably aware that it's actually true in some corner of their minds. One might be emotional because one believes that people who hold certain viewpoints are damaging society. I think self deception from uncomfortable truths has some unique tells which are distinct from sheer negative affect. Some of these are discussed in the "belief in belief" articles - to the extent that they can do so without becoming consciously aware of it, the person will basically act as if they believe the uncomfortable truth is true, even while professing that it is false. I think belief in a good afterlife where we will all be together is the most obvious example of this pattern - most people simply don't act as if death is nothing more a temporary separation when faced with actual death, regardless of what they profess to believe. At some implicit level, I think most people know that the separation is permanent. (There's exceptions of course - I've seen some particularly strong believers who really were relatively unperturbed in the face of death)
0brazil847yI disagree with this based on my general observations of survivalists. I haven't noticed any of them plotting to undermine civilization. Also, I doubt that any of them word do much to prevent a collapse. Also, just introspecting, there are a lot of things I wish were different about the world but I am doing little or nothing to bring about such changes. I think my attitude is pretty common. Perhaps more importantly, even if what you are saying is correct, how does it relate to the subject at hand -- which is predicting which topics will generate a lot of heat in discussion? I agree that other things can get people worked up besides cognitive dissonance. I like that idea. So one can hypothesize that, at a minimum, in any area where a lot of peoples' actions are inconsistent with their professed beliefs, then discussion of those beliefs will tend to generate a lot of heat, so to speak. Not sure that covers everything, but it seems like a good start. And quite possibly those same people remain relatively unperturbed when debating life after death. :)
2NancyLebovitz7yI would assume that if the theory is true, both sides have something they don't want to admit.
0brazil847yLol yes, notice I said "at least one unpleasant truth." But sometimes one side is basically right and the other side is basically wrong.
0Emile7yYou also have the effect of non-overweight people who enjoy being sanctimonious or condescending.
3hyporational7yIt would also be informative what kinds of people find what kind of advice sanctimonious and condescending.
0brazil847yI agree that's a huge problem. On most discussion boards, when the topic of obesity comes up, there will always be a couple guys who show up to say something like "Just stop stuffing your face and you'll lose weight." Which typically generates a lot of bickering. Still, one can ask what is going on psychologically in such situations.
-6Eugine_Nier7y

As you can see a lot of the comments already consist of people misunderstanding each other. I wonder if you could hedge against that in the future by explicitly stating possible communicational failure modes regarding this topic.

[ I am skinny, so haven't given a lot of processing to these issues, please bear with me. ]

I understand there is a controversy surrounding the "just reduce incoming calories" advice. This is obviously true via physics, but people do not seem to find this a satisfying/effective advice. Is the idea that reducing calorie intake enough for physics to take over from biology is too difficult (e.g. you make yourself sick reducing that much, or it is not possible to use that much willpower consistently, or etc.) (?)


edit : in case it's not obvious, I ... (read more)

8kalium7yYes. Constant hunger is extremely distracting, and overall more unpleasant than being fat. The trick is to find a way to avoid hunger while maintaining a calorie deficit. I've seen plenty of claims that fat and protein are more satiating per calorie than starch, but I don't know whether they're valid.
7drethelin7yboth. And also that if you use methods that aren't just based on spherical cows you'll get better results.
5NancyLebovitz7yHave a stored rant that I was thinking about posting to this thread. I believe that "calories in, calories out" is fair-to-middling literally true, but a connotative disaster. It ignores quality of life, health, and life itself. That last refers to very fat people who were put on very low calorie diets and died of heart failure. It is reliably dumped on people who have trouble losing weight. As far as I can tell, not losing weight is at least both people getting sick from pushing their weight too low-- ordinary illnesses, which I assume is the body not sending enough calories to the immune system-- and that it's more willpower than people want to put into the project. I've also got a little evidence that there may be an emotional piece-- I lowered my anxiety level, found I had much less desire to eat when I wasn't hungry, and lost about fifteen pounds without putting a lot of effort into it. Since then I've cycled back into wanting to eat when I wasn't hungry and seem to be heading out of it again, but I haven't been checking my weight. On the research side, there's the ACE (Adverse Childhood Experience) Study [http://www.ajpmonline.org/article/S0749-3797(98]00017-8/abstract), which found a correlation with the number of very bad childhood experiences and obesity. I'm a lot less sure about what's going on with health, diet, and weight than most people seem to be, and a lot more sure that a lot of what's going on is status issues.

The purpose of this post confused me. As someone who hasn't read Good Calories, Bad Calories, is this supposed to be a refutation of his central argument? In the intro post, you said the purpose first post will be "to look at what Taubes is proposing as an alternative [to mainstream nutrition]."

That implies that your response to this is meant to be a general refutation of this idea. But, to me your response feels more like a nitpick. Disagreeing on whether eating more fats has few effects on fat accumulation, or absolutely no effect, doesn'... (read more)

2ChrisHallquist7yNo, this is mostly just explaining what Taubes is defending when he defends Atkins. Refutation of his main arguments comes later. If I did this again, I probably would have combined this with the subsequent post.

Maybe I missed it somewhere in the discussion, but: in the model of "calories in, calories out", is it assumed that all excess calories go towards building more weight?

3ChristianKl7yIt assumed that they will be either stay 'in' and build weight or they will go 'out'. Taken as that it's true. However there are quite a lot of ways that energy can go 'out'. I can sometimes produce enough heat while laying down and meditating to relax to sweat. I'm weighing at the moment 55kg. My weight through the last 5 years was all the time between 53 kg and 58 kg. There are instances where I lost a kg of body weight over night for no apparent reason. On the other hand throwing 800 kcal of maltodextrose per day into my tea didn't gave me an effect of my weight that I could see in daily tracking data even through I took it for months and then stopped with it.
3NancyLebovitz7yIn some versions. At a minimum, it's assumed that all calorie deficits will be made up by taking fat out of storage.
7Locaha7yThis is strange. Why is the model so simple? It's written nowhere that the human body must convert all calories to fat and must take all calorie deficits from fat. In the hypothetical situation where you eat X calories at 40% efficiency, switch to eating 0.5X calories and your body switchs to 80% efficiency, you end up eating half as much calories without changing your weight.
7NancyLebovitz7yIf you push, people who say "calories in, calories out" will probably say "But you have to have some common sense-- of course, I meant some sort of muscle-sparing strategy". However, I believe the fundamental motivation is bullying-- it's an excuse to tell fat people they shouldn't care about their quality of life. Trolls will tell fat people to just stop eating.
1ThrustVectoring7yThat's not a particularly charitable interpretation. "Calories in, calories out" feels like the same kind of simplifying reduction that a lot of other scientific models have. It's one of those statements that's parsed like a natural law. It's perpetuated by an emotional need to have a model where you can control your own destiny. Skinny people want such a model because they enjoy having skinniness be a character trait. Fat people want such a model because they need to hope - to have the counterfactual of "if only I did this action, then I'd be skinny". The truth lies somewhere in between. Losing fat and keeping it off is more complicated than "eat less", and less difficult than "absolutely nothing you can ever do will change how much fat you have on you." The obesity epidemic in America is evidence of this - it's not caused by character flaws so it's more complicated than eating less, and it's caused by something so you can do that same something to reverse the effect. The answer is likely some combination of iterating through strategies until you find the one that works for you, fixing emotional or life issues and your relationship with eating, and learning broad strategies that help your life in general.

It's a subject where I have a hard time being sane, and I'm not aiming for charitable. It's possible that I should cut people more slack for meaning well, or at least not knowing how much damage they're doing and not wanting to know how much damage they're doing, but it's beyond me at the moment.

People who have cancer are congratulated on losing weight. People in depths of dangerous eating disorders are told how good they look, and the compliments dry up when they get healthier. People who use weight-increasing anti-depressants to not be suicidal are told to give up the drugs.

I grant that it's easier to prove that the culture is insane on the subject than to prove that losing fat isn't a good health strategy.

You haven't addressed the question of how urgent it is for people to lose weight.

"Iterating through strategies" is only a good idea if the strategies are low cost-- and a fair number of them aren't.

I grant that it's easier to prove that the culture is insane on the subject than to prove that losing fat isn't a good health strategy.

The culture is insane on the subject, and losing fat is very good for you. That's what makes it tricky - if you start fighting the cultural insanity and meanness to fat people in a naive way, you wind up with the reversed stupidity that is Healthy At Every Size and This Is Thin Privilege. Personally, the answer for me was to get my life together - I moved across the country away from my parents, moved in with much more emotionally healthy sister, went on a keto diet and lost fifty pounds (5"10' male, ended high school at 160, went from roughly 220 to 170). Getting my shit together happened first - and then the weight loss was almost an afterthought.

You haven't addressed the question of how urgent it is for people to lose weight.

You can lead a horse to water, but you can't make them drink. Fat loss is fine and all, but most people got fat for a reason. I know I did - an extraordinarily stressful college environment combined with social isolation. I could deal with leaving those emotional needs unmet - for a time - if I was meeting at leas... (read more)

5NancyLebovitz7yWhat is your evidence that losing fat is very good for people? I'm going to ask for a pretty high standard-- at least five years of fairly stable fat loss, outcome-based evidence of improvement, and a reason to think that the improvement isn't from exercise and/or a low glycemic diet. Some people don't lose a lot of fat doing those things, but they do get healthier. Strategies aren't just about what works and what doesn't. Some strategies make things worse for some people, and it's hard to get information about that and harder (impossible?) to get statistics.
3ThrustVectoring7yI may have inverted the whole cause-effect thing -- after all, I did just admit that doing better in your life makes it much easier to lose fat. So it's entirely plausible that doing better means that you simultaneously lose fat and do other things that make your life better/healthier. Overall, body fat isn't the node you want to target anyways, but rather the vague overall level of healthiness and life satisfaction. I believe there's influence going both ways -- that is, losing fat helps many people live healthier and more fulfilled lives, and that having a healthy and emotionally fulfilling life makes it easier to lose fat. I don't know enough to make an analysis of the relative merits of telling people how to change eating habits X, Y, and Z, as compared to teaching them strategies to deal with their emotions and interpersonal relationships in a healthy way. I do know that they're both vaguely good ideas with obvious benefits and opportunity costs, and definitely better than meandering along the same kind of strategies that lead them to want to make changes in their life in the first place.
2Ishaan7yGastric bypass patients are an example of a population where there is reason to think that the stable weight loss is due mostly to fewer total calories, and they do seem to experience positive effects. Liposuction, on the other hand, does not seem to share this positive health profile. (Of course, the "fat loss" in liposuction is very location specific)
1brazil847yI doubt there is any direct evidence since it's pretty unusual for people to lose weight and keep it off for at least 5 years. And probably a lot of those people adopted lifestyle changes which would have been very good for them regardless of whether they lost the weight or not. Still, I think it's reasonable to believe that losing fat and keeping it off (assuming that you were obese to begin with) is a healthy thing for a couple reasons. First, one can analogize obesity to cigarette smoking. Evidently, both things cause harm to your body. But it's well known that if you quit smoking, over time the excess health risks due to smoking go down and after 15 or 20 years your risks are pretty close to those of the never-smoked population. Common sense says that it should work in a similar manner for weight loss. Second, I believe that there is research showing that objective measures of metabolic health such as cholesterol levels; blood sugar levels; and blood pressure tend to improve in obese people who lose weight. Again, this is suggestive that losing fat is good. This is also consistent with common sense. If excess fat increases your risk of health problems, then losing that fat ought to reduce those risks.
0NancyLebovitz7yHowever, if very few people keep the fat off, then the effects of regaining it also need to be considered.
2brazil847yBy the way, here is an excerpt from the blog of an obesity researcher: http://www.weightymatters.ca/2012/03/why-haes-may-never-go-mainstream.html [http://www.weightymatters.ca/2012/03/why-haes-may-never-go-mainstream.html] When you think about it, there's some sense to this. It's reasonably to hypothesize that the human body is adapted to weight cycling (at least to some degree).
0brazil847yYes, I completely agree.
1kalium7yReduced weight seems obviously helpful if you have bad knees or some other joint problems. As for general overall health, I haven't a clue.
1NancyLebovitz7y"Seems" is the operative word. There are a fair number of people who say that losing weight helps their knee and/or hip joints. However, I've also read accounts by people who found that losing weight didn't help, but getting medical attention for specific problems did. Ragen Chastain [http://danceswithfat.wordpress.com/2011/07/18/my-joints-my-fat-and-me/], a fat athlete, has found that her knees are successfully treated by being given the attention and treatment they'd get if a thin person had the same knee problems.
0NancyLebovitz7yWhy the down votes? The comment doesn't seem especially different to me than my usual.
5kalium7yI didn't downvote, but "Ragen Chastain, a fat athlete, has found that her knees are successfully treated by being given the attention and treatment they'd get if a thin person had the same knee problems" is not relevant to the discussion. I'm aware that it's pretty common for doctors to suggest weight loss as a sole solution when this is inappropriate and other treatment is needed. But by "helpful" I did not mean "sufficient" or "a complete cure" or anything like that, or even "helpful in all possible particular types of joint problems", and I think this should have been clear from a reasonably charitable reading of my comment.
0NancyLebovitz7yThat losing weight will help joint problems seems obvious, not just to doctors, but to the general public-- I've talked with people who don't seek other care for joint problems because they assume that weight loss is the one correct solution. The belief that weight loss is the one and only approach can occasionally be deadly. The comments to the Chastain article include an account of a woman whose doctor told her that her back pain was caused by her being fat. The bone cancer wasn't noticed in time. You did say "seems helpful" rather than "the one and only cure", but I'm honestly not sure how careful I should have been. It does seem reasonable to me to point it out when something that commonly seems reasonable is actually not reliably true, especially when the stakes are high. The stakes aren't usually life and death, but years of pain from a joint problem isn't a small thing.
1brazil847yI didn't downvote your comment, but I would point out that Ragen Chastain is not a very credible source. For example, check out this video: http://www.youtube.com/watch?v=xwzz6STWp8g [http://www.youtube.com/watch?v=xwzz6STWp8g] "I once even had a doctor prescribe blood pressure medication before my blood pressure was taken." Sorry, but that's not very believable. At best it's a self-serving uncorroborated statement. By the way, I don't think there's much rhyme or reason to a lot of the upvoting and downvoting which goes on here.
0[anonymous]7y(Of course it depends on how much fat those people had before.) Admittedly not terribly strong evidence, but see Figure 1 in this study [http://www.nejm.org/doi/full/10.1056/NEJMoa1000367].
0NancyLebovitz7yIt doesn't look at the effect on mortality (if I read it correctly, it's at least using actual deaths rather than an estimate) of losing fat or trying to lose fat.
2DanArmak7yThat anecdote doesn't even separate cause and effect. Maybe you lose weight because you moved, and the diet had no effect. Or maybe your emotional state improved because you lost weight, and moving had no effect - big changes in weight are known to cause or at least correlate with emotional changes. Everything happens for a reason, but most events have many complexly interacting causes, not a single unentangled one. So your claim needs a lot of evidence, and as far as I can see you're not explicitly presenting any.
8ThrustVectoring7yIt was the diet, full stop. The diet was months after moving, and I stayed at the old weight before starting the diet, and I stopped losing weight when I went off the diet. I wouldn't have lost weight without the diet, which wouldn't have happened without moving. It's really the difference between A->C and A->B->C. The counterfactual where I successfully go on a keto diet without the social support of my sister isn't something that would have happened. Let me be more specific in the counterfactuals I'm envisioning. You tell a person with a comfort eating problem to go on a specific diet, and they wind up saying they're on a diet but end up hiding their comfort eating. Any amount of diet advice is not going to work for them because dieting is solving the wrong problem. The right solution is teaching emotional awareness, alternative strategies for meeting your emotional needs, and general skills for improving your life. I'll retract the "most" part of "most people got fat for a reason", because even if it's true I don't have the data to say that - all I really have is a story about how diets fail for people with certain issues.
-7Eugine_Nier7y
1DanArmak7yIf indeed it's an epidemic - that is, highly correlated in space and time - it's very unlikely that the cause can be found and fixed in purely personal terms like 'emotional and life issues', which are unlikely to have changed in tandem for the US population recently.
2ThrustVectoring7yAgreed 100% - it's much more complicated than just emotional overeating, and perhaps my views on the subject are colored by my own experiences. Diet, exercise, education, lifestyle choices, etc all play their part as well. I disagree. It's fairly straightforward to cause a lot of emotional and life issues for people. We did it during the Vietnam War with the draft. College debt is a more contemporary example. Or we can have macroeconomic factors that, on the margin, move people away from friends and family or take more stressful jobs with longer hours. Hell, even the transition from manufacturing to service and knowledge jobs can do it - if you close down a factory and re-employ the workers by having them deal with irate customers as part of their day, you can contribute to more emotional and life issues.
2DanArmak7yMany countries have been involved in terrible wars, then bounced back quickly to affluency that permits casual overeating (on a financial level, that is). Almost none of them developed an obesity epidemic. Even more countries have had economic troubles, and yet ditto. It doesn't seem to me that your model has real explanatory / retrodictive power. How well does the US obesity epidemic correlate in time with the e.g. the Vietnam war? (And with the people who were drafted vs. those who weren't?) Perhaps more importantly, if you're willing to include less drastic things like college debt, I think very few generations haven't had a comparable trauma of some sort, and yet they did not develop an obesity epidemic.
2DanArmak7yIt's sort of true by definition, if you make 'calories out' inclusive enough. Which makes the statement tautological, which is why Taubes says it doesn't explain anything. Almost all people spend more calories on base metabolism [http://en.wikipedia.org/wiki/Basal_metabolic_rate] (what they would spend if they lay in bed without moving for 24 hours), than they do on physical activity. We can also spend significant energy on heating ourselves if we're cold, or just due to different metabolic states. There are probably other categories too. There are also issues of varying efficiency in digestion and absorption; two people may eat the same food but end up gaining slightly different amounts of calories.

It's one thing to claim that, all else equal, low-carb diets have advantages over low-fat diets. It's another thing to claim you can eat unlimited amounts of fatty foods without gaining weight.

Allowing something is not the same thing as recommending it. People eat because they are hungry.

If you are writing a diet book than you give the reader heuristics. The diet should be judged by the effect of those heuristics.

Thanks for writing this series. It takes courage to do so.

ETA: change that to resilience.

I'm interested to read this series of posts.

My current view is that weight loss (or gain) is simply (calories eaten - burned). Period.

There are lots of variables in regard to the psychology of dieting, physiological advantages to consuming certain foods and nutrients & genetic predispostion of metabolism but, at the end of the day, I think dieting and body weight is fundamentally about simple caloric arithmetic and Atkins works through the drastic reduction of the type of calories that make up 40-60% of American diets: carbs.

I'd love to update my view given sufficient evidence.

My current view is that weight loss (or gain) is simply (calories eaten - burned).

This is like saying that the success (or failure) of a product is simply (revenue - cost). Or that the key to winning a sporting contest is to score more points than the other team.

6hyporational7yIf you're going to argue that certain diets make it easier to eat less, why attack the "calories in, calories out" position like that (complain it's simplistic when it's true)? It's just going to confuse the hell out of your readers. Whether you're dieting, devising a product or competing at sports it helps to know what the goal is, because you can usually get to it in various different ways. Edited for hopefully a bit more clarity.
-3Jack7yHuh?
4hyporational7yWhich part confused you? "Huh" won't help me to help you, nor will it help me understand you.

The whole thing confused me, but the edit helps a bit. There is nothing particularly wrong with "Calories in, calories out" it just fails to illuminate anything at all which is why it's a bad response to make to any claim about the effects of diet. It also, as a practical matter leads to people thinking about their size as the result of a system where their best control levers are how much they eat and how much they exercise. If trying to eat less and exercise more is a bad way to try to lose weight then attacking the model as simplistic (despite it being a tautology) seems like a reasonable thing to do. That is-- aside from being uninformative it also seems like it might have counterproductive effects as far as people interpret it as dieting advice.

5Brillyant7yI sense there is a great deal of bias surrounding this topic. The goal is to lose weight, right? And this guy being discussed is an advocate of the Atikins diet, right? All I meant (and all I said) is that "Atkins works through the drastic reduction of the type of calories that make up 40-60% of American diets: carbs." I conceeded that "There are lots of variables in regard to the psychology of dieting, physiological advantages to consuming certain foods and nutrients & genetic predispostion of metabolism" And concluded that "dieting and body weight is fundamentally about simple caloric arithmetic". ... From my wikipedia reserach, Atkins includes a two week "Induction" phase which involves what appears to me as nothing more than carb-eliminating & portion control. Over the course of two weeks, I posit two things tend to happen to an Atkins dieter: (1) they lose weight through a rather dramatic reduction in calories & (2) they form some habits. (1) leads to some increased positivity and will to continue & (2) helps them stick to the diet with less will power expenditure. (In many cases I've seen, and as a result of their increased will positivity and new habits, people incorporate some other helpful weight loss measures concurrently, such as consistent exercise, which furthers their efforts.) You seem to be suggesting this is more complicated and magical than I think it need be, and then critiicizing my simpler solution. OF COURSE dieting is hard because of lots of well established psychological and physiological reasons. I'm not trying to discount that. But pretending Atkins works primarily by some other mechanism other than calorie reduction is, in my current opinion, not true. If I'm wrong, show me. You mentioned insulin as a variable I'm ignoring... And then you said cases like those "don't make up a very significant fraction of people who are obese in the modern, western world". ... By the way, I think I've made this clear, but I'll make it cle
-2brazil847yThey also lose a lot of water weight. Well I think the hypothesis is that by eliminating refined carbohydrates, you are adjusting your body's internal "food clock" so that you will naturally end up eating less. So it's analogous to the Shangri La diet, except that the Shangri La diet purports to adjust your internal "food clock" through a daily shot of flavor-free calories.
2ChristianKl7yThat's wrong. There meaningful disagreement about whether "Calories in, calories out" is true. Deciding whether it's true matters. There are three positions: 1) It's the calories stupid. People should count calories and reduce their intake an then they will lose weight. 2) People can't just reduce calories easily. They need to take into account all sorts of psychological factors to successfully reduce calorie intake. This means making certain food choices that result in different levels of hunger. 3) Calories in doesn't matter much, you can eat 4000 kcal a day like Dave Asprey and still be fit and not gain additional weight. There are plenty of paleo folks who argue 3) in some form but most not as strong as Dave Asprey. It's imporant to know when someone argues in favor of 2) and when in favor of 3).
0Jack7yThere is meaningful disagreement between those positions, but none of them dispute conservation of energy.
1hyporational7yThanks for the clarification. It illuminates the goal. There are smart and stupid ways to achieve that goal. I think simple calorie restriction without other concerns is a stupid way to achieve that goal, but I also think scolding anyone who states the goal is damaging to the goal of making people smarter about their diets. Through the power of connotation it's just going to make you look like a perpetual-motion-machine-quack to anyone not familiar with your arguments. It could also make them come up with smarter ways to restrict calories the easiest way possible, which could be limiting carbohydrate intake. ... but it isn't. The question is how you do it, and I think you agree. People interpret low carb diets all the time too as a permission to eat for pleasure as much as they want. Hedging against misunderstandings is advisable no matter what we're talking about.
3brazil847yHaving thought about this some more, I think it's a good point. The problem with the soccer game analogy is that everyone is completely and acutely aware that you need to score more than the other side in order to win and that that's the only way to win. With dieting, weight loss, and obesity, a lot of people vaguely believe that calories don't matter; that there are a lot of thin people who eat lots and lots of food and stay thin; that there are a lot of fat people who eat very little food and stay fat; and so on. Of course it's in Taubes' interest to have some vagueness on this point since he can sell a lot of books by being perceived as giving people permission to pig out.
-3brazil847yWell is that a misinterpretation?I I had this exchange with poster "Jack" a few posts back: Me: Jack:
2hyporational7yIt should be since he admitted that too much energy leads to weight gain. I suspect he meant that people naturally restrict their intake on certain diets, so you don't have to give them explicit warning about eating too much. This leads me to believe some people are suffering from a typical appetite bias. Eating to satiety isn't the same thing as eating for pleasure. I could easily triple or quadruple my energy intake if I didn't have to worry about getting fat. This is why I try to make my food not too tasty and handle it more business-like.
-6Eugine_Nier7y
0[anonymous]7yThere are three positions: 1) It's the calories stupid. People should count calories and reduce their intake an then they will lose weight. 2) People just can't reduce calories. They need to take into account all sorts of psychological factors to successfully reduce calorie intake. This means making certain food choices that result in different levels of hunger. 3) Calories in doesn't matter much, you can eat 4000 kcal a day like Dave Asprey and still be fit and not gain additional weight. There are plenty of paleo folks who argue 3) in some form but most not as strong as Dave Asprey.
4Brillyant7yUnless I'm wrong, there is a large chunk of the population who believe diets have some magical element that differentiates them from other diets. Atkins, from my limited understanding, involves a magical element, coming up with a sciency-sounding explanation for it.
5Jack7ySo people undergoing insulin treatment (for example) get fatter because they start overeating and stop exercising enough?
7Raoul7yI think Chris is probably taking Taubes a bit literally (and I agree with the revenue-cost analogy), but I like http://wholehealthsource.blogspot.com/2011/08/carbohydrate-hypothesis-of-obesity.html [http://wholehealthsource.blogspot.com/2011/08/carbohydrate-hypothesis-of-obesity.html] , which he linked to in Part 1. There's quite a lot in it about insulin (too much for me to summarize here), but I've copied a couple of particularly relevant paragraphs below. Obviously if you can see any issues with them then I would be interested in hearing them. "The idea of fat gain in insulin-treated diabetics (argument #3) is not as airtight as it might at first seem. On average, diabetics do gain fat when they initiate insulin therapy using short-acting insulins. This is partially because insulin keeps them from peeing out glucose (glycosuria) to the tune of a couple hundred calories a day. It's also because there isn't enough insulin around to restrain the release of fat from fat cells (lipolysis), which is one of insulin's jobs, as described above. When you correct this insulin deficiency (absolute or relative), obviously a diabetic person will typically gain weight. In addition, short-acting insulins are hard to control, and often create episodes where glucose drops too low (hypoglycemia), which is a potent trigger for food intake and fat gain. "So what happens when you administer insulin to less severe diabetics that don't have much glycosuria, and you use a type of insulin that is more stable in the bloodstream and so causes fewer hypoglycemic episodes? This was recently addressed by the massive ORIGIN trial (17d). Investigators randomized 12,537 diabetic or pre-diabetic people to insulin therapy or treatment as usual, and followed them for 6 years. The insulin group received insulin glargine, a form of long-acting "basal" insulin that elevates baseline insulin throughout the day and night. In this study, insulin treatment brought fasting glucose from 125 to 93 mg/dL o
6Jack7ySo I don't take the weight gains from a high-carb diet to be directly analogous to a diabetic injecting insulin. Mainly, I'm talking about artificial insulin injection here just as a simply rebuttal to the notion that weight gain/loss is entirely about eating too much/ not exercising enough. People naturally tend to underestimate how much biochemistry influences decisions, mood and personality. It's a product of lingering Cartesian mythology. That said, most of what I've seen on insulin and leptin resistance emphasizes peak insulin level in the minutes to hours after eating rather than a moderate difference in baseline insulin. What is going on is probably more complicated than a straight-shot from carbohydrates to insulin to fat. We probably need a more committed, more knowledgeable or less busy defender of Taubes here.
2Raoul7yThen it's a good example, and I'm with you that your weight is determined by more than whether you have the willpower to say "today I'm going to exercise and not eat too much". (Though most researchers probably agree with Taubes on this: http://wholehealthsource.blogspot.com/2013/01/comment-in-nature.html [http://wholehealthsource.blogspot.com/2013/01/comment-in-nature.html] .) I think Stephan on Whole Health Source does a good job of refuting Taubes' claims on the particular importance of insulin resulting from carbohydrate consumption (I can't remember specific posts, but I think there are several others in addition to the one Chris linked to), but it might be that I would think otherwise if I were a bit more knowledgeable. He had some sort of falling out with Taubes at some point, and, like Taubes, he has a theory about what causes obesity ( http://wholehealthsource.blogspot.com/2011/11/brief-response-to-taubess-food-rewad.html [http://wholehealthsource.blogspot.com/2011/11/brief-response-to-taubess-food-rewad.html] ) and is presumably disproportionately likely to interpret evidence in ways that support his theory.
1hyporational7yFor example, it's not clear to me whether you are for or against this position in form of a question. Should it be?
3Jack7yI don't think weight gain from insulin treatment has anything to do with the diet and exercise decisions people make. Obviously, as a matter of fact they take in more calories than they burn.
2hyporational7yI think you're correct, but I'm not sure how this translates to low carb dieting. You can make any healthy person eat too much if you give them insulin. Give them enough, and they will die if they don't. Some diabetics obviously take too much insulin, and this will make them eat more. Taking too much insulin is a decision. Do you find this agreeable? A common problem with diabetics is many of them eat unnecessarily large evening snacks out of fear of nocturnal hypoglycemia even if they take just the correct amount of insulin. This leads them to get hyperglycemia in the morning, which leads to upping the dose and the cycle continues.
0NancyLebovitz7yFrom what I've read about diabetes, the need for insulin varies somewhat unpredictably. It's hard to be sure one has taken just the correct amount.
2hyporational7yThat's true especially in the beginning, but people become incredibly good at predicting how their needs vary through experience. Getting sick is an important exception, that's when things go wacky. Do you think whether we use the word "just" or "roughly" was important to my main point?
0ChristianKl7yGary Taubes argues that someone who eats more carbs is going to produce more insulin. Froom Good Calories, Bad Calories:
0hyporational7yI think the hypothesis is plausible, and if it were true the amount of carbohydrates people tolerate before their insulin secretion went crazy probably would vary greatly. I'm not sure if it applies to fructose, since its cell uptake doesn't seem to be regulated by insulin. I'm pretty much ready to accept this idea as one of the major causes of obesity, but not necessarily the most important. Does he say anything about insulin resistance in relation to this idea?
0ChristianKl7yFar as as I understand he see a lot of insulin resistance as the result of elevated levels of blood insulin. I think he makes that argument in more detail and I'm probably not the right person to recount all the details. I personally don't think that there's something like a ultimate cause of common obesity and that there are probably a lot of different factors at work.
0hyporational7yIf they get hypoglycemia because of too much insulin then yes, this would make them eat more. If you're hypoglycemic you won't like to exercise either. If insulin can store energy from thin air, I would like to understand the mechanism.
0Jack7yAgain, huh? All of your replies in this thread sound like they're replying to a position I haven't taken.
2hyporational7yPerhaps you should make it clearer what your position is then. The ifs were there because I wasn't sure I understood you, so I was replying to a hypothetical.
0Brillyant7yI'm ignorant as to why that happens, and I'll assume it is true. Why does it happen? And what percentage of the general population do circumstances like this (or other such examples) apply to?
1Jack7yWell that's what insulin does [http://science.howstuffworks.com/life/cellular-microscopic/fat-cell2.htm]. It's the hormone that mediates growth in adipose cells. If a person has broken insulin regulation (aka diabetes) and then you start injecting them with the stuff there is a good chance they'll get fat (the effect of insulin is a little more complicated than that, such that people react differently-- obesity has a significant genetic component). There are a lot of known hormonal and metabolic disorders that can cause obesity. They don't make up a very significant fraction of people who are obese in the modern, western world-- but it in some societies it's probably the only way some people ever get /got fat.
1Brillyant7yI would agree this is true. From my recall and simple research, something like ~17% of individual metabolism is dependent on factors that are suspected to be genetic, and this, as a result of simple arithmetic, can lead to obesity fairly easily. (e.g. we eat and exercise identically and end up at very, very different weights). I still don't understand what the mechanism by which -- apart from simple caloric arithmetic -- Atkins works? Are you saying it is a result of its effect on insulin in the body? Since, like you, I don't suspect (though we may be wrong) insulin-caused obesity is a significant % of the western world, it still is my view that the Atkins diet is primarily nothing more than an "eat less" diet disguised as pseudoscience.
0hyporational7yThe genetic component could also affect hunger and eating behavior.
0Brillyant7yIt seems to me reasonable (and likely) that it does. Of course we have individual differences in appetite and metabolism. The crux is what Atkins, or any diet, does besides improve caloric arithmetic. I'd say it does primarily nothing in the majority of people. I'd love to hear a suitable counterproposal.
0[anonymous]7yNot going to happen. Apparently people are going to argue that certain diets make it easier to eat less calories, and make the explanation as obscure as possible so that it looks like they've invented something new.
0hyporational7yExamples?
3Jack7yBasically all hunter-gatherer societies, as far as I know.
2hyporational7yAh, that's reasonable, but could be just because food is more difficult to get, and exercise isn't optional.
5Nornagest7yThe issue's a bit more complicated than that. Skeletal evidence shows us that overall nutrition is usually worse after the agricultural transition, with average heights (a decent proxy for nutrition) usually dropping by several inches after a region switches to an agrarian lifestyle. This doesn't necessarily mean that agrarians are making fewer calories per unit effort, though. They may be limited in protein or micronutrients but not in calories, with stunting thanks to deficiency issues; actually that's rather plausible. Alternately agrarian methods might by limited by expenditure of effort during some limited season (plowing, say, or harvest -- I don't know exactly how bronze-age agriculture worked), which could give you higher peak effort but lower average effort. Or the aristocratic classes that usually come with an agrarian transition might be confiscating all the good stuff for their own use. (Agrarians are making more calories per unit land no matter how you slice it, but that's more historically than nutritionally significant.)
0hyporational7yThe question was whether there were any non-hormonally obese people, not what the average person looked like. I'm pretty sure agriculture made it much easier for high status people to overeat. In fact, obesity was probably a status symbol.
3Jack7yWhat's weird is that agriculture-- or at least the modern food system apparently also makes it much easier for low-status people to get fat, even when their children are starving [http://lifestylenutritionmassage.com/wp-content/uploads/2012/12/A-Nutrition-Paradox.pdf] -- pdf.
0hyporational7yHaving children is not about reproduction, it's about locally high status ;) Thanks for the paper.
1Douglas_Knight7yThe example is hunter-gatherers, not agriculturists. The point of discussing farmers is to address your suggestion that food is hard for hunter-gatherers to get. By many measures, it appears easier for hunter-gatherers than for farmers. In particular, hunter-gatherers appear to eat more and work less.
-2[anonymous]7yYou think it was easier for high status hunter gatherers to get copious amounts of food than it was for high status aristocrats fleecing farmers? Just to remind you, this [http://lesswrong.com/lw/je4/critiquing_gary_taubes_part_2_atkins_redux/a8sb] is where it started.
1Nornagest7yThat's a harder question to answer, partly because fat doesn't preserve well in the archaeological record. A quick trawl through Google Scholar isn't picking much up for the archaeological side of the question, although I've found a surprisingly large number of cites discussing the proportions of the apparently-obese "Venus" figurines sometimes found in Upper Paleolithic sites. This paper [http://www.plosone.org/article/info%3Adoi%2F10.1371%2Fjournal.pone.0040503] on the other hand seems to suggest that the answer is "no" for at least one group of modern foragers, at least to a first approximation (the sample size is rather small) and modulo the usual caveats re: modern foraging cultures.
0[anonymous]7yThat's the first thing that came to my mind too after that first paragraph. Agrarian efforts require different kinds of manual labor too that burn a lot of calories. Certain kinds of intense exercise stunt growth, I think.
4Randy_M7yAny insufficiently understood biological process will be indistinguishable from magic.
2[anonymous]7yBeing reminded of obvious things isn't always useless. (For example, Stein's law “If something cannot go on forever, it will stop” is a tautology if you think about it, but...)