Food noise and GLP-1 effects

Published 4.26.2024: It's been awhile since I posted, but I have some time today and decided I'd post a few interesting links that I've come across recently. Ozempic and other versions of GLP-1 drugs are a hotly debated topic. Many members of the fat activists online community have decided to take them, or have considered or even had weight loss surgery. Many others have denounced such efforts as "fatphobic."

Jillian Michaels is not a fan of GLP-1s, her livelihood would be impacted if they were to become standard care. That's not her public reasoning of course, but that's the effect that is likely focusing her opposition. Of course, all drugs have side effects… but if you believe that obesity is a disease (I don't) then I'm not sure why the need to take a drug chronically is such a big deal. People take blood pressure medicine for the rest of their lives once diagnosed, and many people take statins for chronic high cholesterol. If you stop taking those meds, your blood pressure and cholesterol will rise. If you stop taking the drug that helped you lose weight, you will regain weight.

Nor are GLP-1s all that new. It IS new that they are being used to treat obesity, but GLP-1s as a class have been used to treat type 2 diabetes for years. Not without side effects, but it's not like people have died from these drugs— as was the case with previous weight loss drugs. That is why people focus on side effects though, because history is not in these drugs' favor.

On way that GLP-1s work (for those for whom they work, they do not work for everyone) is that they quiet the "food noise," which not everyone accepts as a real thing. At least one commentator has suggested that a synonym for food noise is just hunger. Which any fat activist would tell you is to be respected and revered in all cases. Even if you're so fat that you've started to have health issues related to the excess weight.

For me, I take people at their word. If they think that's the effect of the drug, then that's the effect. I think it's disrespectful to tell people on the drug that they aren't having the experience that they are are having. At least one person taking the drug for awhile (at least 2 years) notes that the silencing of "food noise" diminishes with time. Thus it will be interesting to see what people (Rosie O'Donnell and Oprah Winfrey for two examples) who rave about the effects of the drugs start to say when the drugs start to wear off.

According to Kevin Hall's recent calculations, GLP-1s and weight loss surgery double the time to the onset of diet plateau, which is (in part) why they work. All bodies react to restriction, and plateaus are inevitable. Using the drugs or surgery, the plateau is not avoided, it's just pushed off. It seemed to be time related, rather than related to the amount of weight lost. This might explain why Rosie and Oprah are still gungho on the drugs, neither one has reached the plateau state. On the other hand, maybe they have and are happy with the weight loss to date. But at least for O'Donnell, at the time that I heard her on a podcast, she was still losing a small amount of weight each month. Both she and Oprah tout the lack of "food noise," which I probably shouldn't put inside scare quotes since I believe it's a real thing.

The drugs (and surgery) cause a greater calorie deficit to be induced, roughly twice what people do on their own. So if on your own you try to cut 600 calories, the drugs will cause you to cut (spontaneously?) 1300 calories or more. Clearly these subjects are large people with big appetites. I accept that I am eating more than the calorie counters tell me I need to eat to lose weight, but there's no way I could cut 1300 calories from my diet and live. My guesstimate (and that's all it is because I don't track anything at this point) is that I eat 2100-2300 calories a day (which is why I can't lose any weight). To lose weight per the counters that number needs to be closer to 1700, and to maintain that new weight I'd have to be between 1800 and 1900. That's doable (for me, I'm a very short female) but I don't want to do it. I say I want to do it, but then I don't. There is no try, do or do not. Plainly, I do not.

Hall's latest paper is a mix of modeling and comparing the results of actual human trials, which fits with his physics approach to nutrition. Trying to mathematically model the human body. Wow, do some people dislike this effort, at least based on social media posts… which is a terrible way to judge reaction to anything… but I digress. The drugs tamp down appetite during regain as well, which maybe why longer term studies (up to two years) show regain, but not the gain of additional weight. Basically, the smaller body signals that it needs more calories, and the more you use the higher the signal becomes.

Surgery has the greatest effect of any intervention, but weight gain after surgery is possible too. All of the regain is a factor of appetite matching or at least partially compensating for the effects of the drugs or surgery. It's not that the drugs or surgery no longer do what they do, it's that the body is compensating for those effects. However, I'm not sure how different that it to "the drugs no longer work."

All of the above is based on the CNN article and interview with Hall. This is the original article that is open access (at least as of 4.23.2024).

Recently, I have been playing around with so-called "intermittent fasting." I put the scare quotes around the phrase, because essentially I fast every night, when I stop eating and sleep. I break the fast (have breakfast) the next morning. However, there are people (such as the folks behind the podcast and app ZOE) who assert that fasting for at least 12 to 14 hours— or longer— each day increases longevity. I didn't take notes during the podcast, but I was intrigued with the notion that working out fasted in the morning might be a good thing.

I work out very early in the morning, mostly because if I don't work out first thing, I don't work out. That's a me thing, I'm not suggesting that there is any evidence what so ever that this is the healthiest way to be. It is the way I am, and after so many years, I realize that it isn't going to change. I have, however struggled with coming up with something to eat that early in the morning without it "repeating" on me while I work out. Basically a bit of food comes back up into my throat if I eat too much. I had altered my first intake in an attempt to mitigate this effect— and I made progress. Not eating before working out is not thought to be optimal (at least that's what my trainer believes), but the podcast made it plain that for both men and women (who aren't pregnant or nursing) can work out fasted and it's fine.

I gave it a try and it was okay. I think it took a couple of sessions before I felt comfortable with it, but now I wish I'd done it earlier. All of which is a very long winded way to introduce this article, which covers recent research that "time restricted eating" (TRE) or "intermittent fasting" wasn't any better at promoting weight loss if calories were held constant. People tout TRE for weight loss, because giving themselves less time to eat during the day, means they eat less. The energy balance wins again!

This says nothing about any asserted longevity claims related to TRE, it simply suggests that people trying to lose weight might find it easier to limit the hours they can fill their gob rather track their calories. So from the ZOE perspective it doesn't alter their plan. Of course, losing weight for some people will result in improvements in longevity, but that is the case with or without skipping breakfast.

I should note though that ZOE doesn't think you should skip breakfast, if anything you should skip dinner. Skipping (actually delaying) breakfast is what made sense for me. So that's what I do (if I do it).

Dieting should be avoided

Published 2.12.2024: That dieting should be avoided is the overall theme for this piece. Wholly plant based people (also called vegans) don't believe that dieting is necessary, because so many plants are low calorie density. If you don't eat a lot of ultra-processed vegan junk, you should be able to eat all you want and not get fat. I think there are some fat vegans who might disagree. Aubry Gordon (the subject of the second part of this piece) doesn't believe that being fat is a problem on any level. All diets are stupid and mockable to her. And if your definition of diet is limited to fad diets, it's hard to disagree.

Red Pen Reviews reviewed Dr Greger's book, How Not to Diet. Red Pen has a format for how they do the reviews, and generally I think they are fair. Their review of Greger's book is that it's not particularly scientifically accurate, because he takes very weak data to make a fair number of his points. He does document his sources accurately, he just overstates what they say.

Continue reading

Your Fat Friend, the movie

Aubrey Gordon is a fat author and podcaster— she co-hosts the podcast, Maintenance Phase. She began her writing career anonymously, using the handle of the movie title. Eventually, she dropped the mask and has now written multiple books.

She allowed the film maker to follow her for most of 6 years, and the movie, Your Fat Friend, is the result. Full Disclosure: I listen to Maintenance Phase and I have read a number of Gordon's online pieces, but not her books. I have not seen the movie, but only because I don't have the opportunity to do so.

The Guardian has seen the movie and gives it a review that is mostly positive. Louder Than War (a site which I had never heard of) also reviewed it. They note that the film is intensely personal, Gordon's parents come in for a lot of criticism, but also show that Gordon's activism "works." But then the piece segue's into a discussion of the obesity epidemic and societal health concerns, which to my mind remain the weak link in fat activism. Health IS related to weight— and for the record, Gordon doesn't dispute that— at least on her podcast. In the movie, health is simply not discussed much.

Her dispute is how fat people are treated and called. No "fluffy" for her, she'd rather be called fat. The Financial Times, in its review, also notes that Gordon's take that fat is positive is never questioned. I suppose Gordon might say that there is no reason she should have to question her existence, she just is. She attacks the "Wellness" industry (this is a recurring theme on her podcast), comparing it to the tobacco industry. The Financial Times gave the movie 3 out of 5 stars.

Here is another overall positive review. Gordon is also releasing another book along side the movie, the title of which is What We Don't Talk About When We Talk About Fat. I haven't read the book, nor have I found reviews of it. Apparently the movie is being released in the UK before the US. Although further googling suggests that perhaps the film was released in the US, at least at small film festivals. I don't know if there will be a larger release. i would watch the movie if I get the chance.

Fat Body Positivity is in trouble

Published 2.7.2024: I have written here quite a bit about so-called Body Positivity, what I like to call FAT Body Positivity (FaBoPo) because it is my observation that many of the Body Positivity supporters really only mean fat bodies. Thin bodies are considered standard, and well represented in the mainstream. Which I has a nugget of truth in it, but completely ignores the fact that people in bodies of all sizes have issues.

The term "Body Positivity" therefore has fallen out of fashion, and now the preferred term is Fat Activist (FA). I think it's a better term, because it makes it plain that the movement is for, and limited to, fat bodies. And I can respect that. It's not for me (or my daughter) and so I can ignore it. But as FAs have aged, a number of them have begun to lose weight (intentionally, which is taboo) and even with the new weight loss drugs. Holy hell, even Tess Holiday is on a diet. I don't watch Tess Holiday's content, I learned of this news from this YouTuber (whom I have highlighted previously.) I don't disagree with her assessment in this case, and will suggest that you watch her video.

Read the rest.

UPF vs HPF

Published 2.2.2024: Are ultra-processed foods(UPF) the devil? Or is the issue hyperpalatable foods (HPF). Kevin Hall is redoing his UPF study, but this time he's trying to control for hyperpalatable foods (HPF)

Kevin Hall had been leaning into UPF being the issue, until Tera Fazzino from the University of Kansas contacted him and asked him to check to see if his UPF had also been HPF. The unprocessed foods were not HPF and people ate less of them, but the UPF were also HPF, and maybe that's why subjects are more of them. In his study, Hall used a subjective "satiation" metric to compare the two diets, but Fazzino's method is objective. A food has so much fat and salt, or it doesn't.

So Hall is rerunning his experiment with the same nonHPF nonUPF diet, and the UPF + HPF diets, but also UPF diets that are not HPF. Hall also found that the amount of fluid between the diets varied, so they are controlling for that.

My money remains on HPF as being the important characteristic. HPF explains our weight gain over the years, UPF does not. And most UPF are HPF. Regular food cooked at home is not UPF, and can be (by design— no one tries to make unpalatable food) HPF. And people will overeat them, therefore.

UPF is not a requirement for obesity, I think HPF may well be. I didn't realize that NIH can only have 2 subjects at a time in their metabolic ward. No wonder it takes so long to do the studies. Eating UPF might have helped the vegan twins in the recent Gardner study, which was the subject of a recent Netflix documentary and which I wrote about previously.

Coincidentally, I listened to a podcast interview with Tera Fazzino about here research. Interestingly, she thinks that sodium (salt) is the primary driver in hyperpalatability rather than sugar. Although she does include sugar and fat as one category of hyperpalatable foods. Rather than shoe horn that into this article, I think I write up a separate piece about hyperpalatable foods and their effects.
Keep reading.

Weight Watcher's GLP-1 House

Published 1.23.2024: I had no idea the GLP-1 house existed until I watched this video by Sam at Every Size (her YouTuber name). I like this channel and generally start my Mondays watching her.  Naturally some fat activists are up in arms about other fat people are choosing to lose weight.

Fat Body Positivity (FaBoPo) or fat activism seems to be splitting into groups-- those who have decided to lose a bit of weight (though mostly they are still fat) and those who think the only valid change is to gain weight. Weight Watchers (which bought Sequence last year) hosted the house, which had presentations about the drug, but also a lot of healthy foods (they are very focused on protein). For the record, I can understand

The GLP-1 house has only started showing up in a
YouTube search. Initially I couldn't find it, but I suppose most of the influencers were TikTokers rather than YouTubers, so it showed up on TikTok earlier. I don't have TikTok, so I can't search there. 

Sam at Every Size is wondering about the future of fat activism and notes that losing weight is considered suspect (losing weight intentionally). Weight is allowed to change in fat activism, but it's only allowed to go up. Never down. I've made that point many times before. 

Apparently there's a movie called,
The Dark Side of Fat Acceptance, and I can watch it on TubiTV. The movie/documentary is from 2020. What follows is based on my notes while watching.

Keep reading the rest.

Resolutions Time

Published 1.17.2024: This is a perennial resolution post around these parts, even though the anti-resolution folks appear to have won. By that I mean that there are far fewer pieces arguing against setting resolutions for the year. I, however, still write resolutions for each year. I also review the list for last year to see what if any progress I made towards my resolutions (or goals, which somehow are supposed to be better than resolutions). 

For the record, I did the resolutions on the 31st of December. I didn't do great keeping my resolutions last year. The ones I kept were pretty much the same as the year previous. Yes, I continue to make the same resolution even if I kept it, and even if I didn't. Unless I decide for some reason that it's no longer a worthy goal.  

Writing resolutions gives me a chance to assess where I am and where I want to be. And I don't get caught up with specific schedules to meet a given resolution. I give it my best try throughout the year, even if my adherence is spotty (which it most definitely was in 2023). 
 
My daughter also makes resolutions, though she does so differently than I do (and no, we don't share them with each other. It's an internal check, not to be shared with the world in my view). None of the males in the household make resolutions. 

Read the rest.

You Are What You Eat Review

Published 1.5.2024: I haven't had time to do this in awhile, but one result of the changes to my life in the real world is that I had time enough to read the first (of what I'm sure will be many) paper related to the Stanford Twin Diet study and watch the accompanying Netflix series.

The series was four episodes long, and for the most part they didn't drag. This article got a lot of vegans very excited, and it was the basis of the Netflix series. I'm going to talk about both at the same time rather than publishing two different pieces. I have not watched any critiques of the either, good or bad. My suspicion is that both sides will get from it what they expect. Keto/carnivores will hate it and pooh pooh it, which alone is a reason for me to love it.

(An aside: the last seven years have caused me to seriously detest the keto diet. Carnivore diets are also just stupid to me. Humans are omnivores who can survive on almost any earthly diet— that's a feature not a bug. Deliberately eliminating plants is asinine, as is deliberately eliminating animal products or eating only fruit. At least vegans have their ethical arguments to fall back on— even if they are unpersuasive. Humans evolved to eat everything. And across the globe, we do. That doesn't really relate to the topic at hand, but I believe in putting my biases upfront. I think keto/carnivore are stupid fad diets and neither is healthy for most people.)

Read the rest.
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