> And yes, my intuition says that most people are perfectly
> capable of the discipline to change their lifestyle …
> It’s not “this doesn’t work”, it’s either “I didn’t work hard
> enough to make this work,” or sometimes, “this doesn’t
> quite work for me because X.”

My intuition (and lifetime of trying) tells me that the latter is
far more likely than the former.

I’ll follow up in the next thread with the tricks I use to get myself to eat healthier and get my ass on the treadmill. The only major sticking point worth noting ahead of time is that there is only one way to learn discipline, and that is to be disciplined, i.e., fake it till you make it.

(btw John when you changed the URL structure you broke the links in the older notification emails. However since the notification option seems to be gone that may not be terribly useful to you.)

http://weightmaven.org/2010/02/28/obesity-diabetes-and-diet/

http://www.fathead-movie.com/index.php/2010/02/23/energy-balance-why-the-food-cops-have-it-all-wrong/

As an aside, I’m not convinced that going very low-carb is necessary. But I do think moderating carbs (especially sugar and refined starch) is.

So it’s not do diet and exercise work, it’s why can’t people maintain these practices on their own, as compared to being in metabolic ward studies?

I bet we’re going to find out that it is in fact *what* we eat that is causing the problems with insulin resistance and appetite unrelated to physical hunger (some of these tied in to deficiencies like omega 3, vit D, iodine, magnesium). I think there’s also some interesting info coming out about the role of gut health wrt inflammation and weight loss/gain.

So people do well for a while following a healthy diet, but then a special occasion comes up or a something really stressful happens, and people let themselves go back to some processed food, and if they aren’t careful, before long, one meal stretches into two or three or a whole week’s worth, and by then the metabolic things going on are back in full swing.

Interestingly, one of my other regular reads just had a blog post about the brain and obesity that seems relevant. Here’s the money quote:

—–
These findings clearly suggest that brain function associated with food motivation differs in obese and non-obese adults and may well explain the different susceptibilities to weight gain and variability in response to diet interventions.

Given the emerging science on brain plasticity, it is certainly of interest whether or not these differences in brain function are acquired or are indeed innate. Whatever the case, we need to understand and acknowledge that our brains respond differently to the same food stimuli which easily explains why some people may find it much harder to resist overeating in our current obesogenic environment than others.
—–

Go check out the whole thing here:
http://www.drsharma.ca/do-brains-of-obese-individuals-respond-differently-to-food.html

John, very well put.

If the psychological barriers are real and significant, and that prevents most people from successfully completing the treatment, then “eat less, exercise more” is an ineffective treatment strategy because it is not within most people’s reach.

Now, if “eat less and exercise more” doesn’t work—or, at least, requires such significant energy outlays and drastic caloric cuts that most bodies rebel, then what that advice does is encourage dangerous behavior in the name of willpower.  In that case it’s not only an ineffective treatment strategy, it’s a destructive one.

What would be really great, since I am having trouble finding any, is if you could turn up some nice published clinical trials about the efficacy of this particular strategy. Is “eat less, exercise more” a recommendation that’s been tested scientifically? Has the medical profession logged people’s exercise and caloric intake for six months? Do they have any basis other than “common sense” for making this claim?