Weight loss surgeries rise substantially among adolescents: research (opens in new tab)

> telling people to eat right and diet doesn't help outcomes at all

That's only because they don't listen to what you tell them. When people actually do eat right and diet, that works to lose weight 100% of the time.

Here's a follow up to this:

PSA: Every legitimate long term study of major non surgical weight loss shows that it doesn't happen for the vast, vast majority of people. It's basically freakish when succesful in the long term. 1) ["In controlled settings, participants who remain in weight loss programs usually lose approximately 10% of their weight. However, one third to two thirds of the weight is regained within 1 year, and almost all is regained within 5 years. "](http://www.ncbi.nlm.nih.gov/pubmed/1580453)

2) Giant meta study of long term weight loss: ["Five years after completing structured weight-loss programs, the average individual maintained a weight loss of >3% of initial body weight."](http://ajcn.nutrition.org/content/74/5/579.full)

3) Less Scientific: [Weight Watcher's Failure - "about two out of a thousand Weight Watchers participants who reached goal weight stayed there for more than five years."](https://fatfu.wordpress.com/2008/01/24/weight-watchers/)

4) [The reason why it's impossible seems to be that although calories in < calories out works, the body of a fat person makes it extremely difficult psychologically to eat less.](http://www.nytimes.com/2012/01/01/magazine/tara-parker-pope-...) This is borne out by the above data.

5) [The only thing that does seem to work in the long term is gastric surgery.](http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421028/)

Moreover, you won't find any reputable study on the web where the average person in the study lost 10%+ of their body weight and kept it off for five years. Not even one.

Is this satire?

I've lost 120lbs. I'm a PM so I A/B tested different methods to lose weight until I found one.

Exercise did almost nothing. It helped start my metabolism here and there. The real weight loss came from just eating as close to 0 calories a day as possible. Water, lettuce, whatever gets you full. It's a grueling process. It's not something you do because you love your body and your habits. You have to hate them.

Feel free to recommend running shoes and gym memberships to people. In my experience, your comment isn't grounded in data, experience, or even helpful. It comes across as dismissive and wanting to sound right.

The people doing these operations are suffering through a level of anguish you can't imagine. They are well aware of your trite advice, and unable to get their problem solved. That's why they turn to painful, expensive surgery.

It's a problem, and playing armchair life coach with gotcha one liners isn't going to solve it.

That's kind of like telling a smoker all they need to do is quit smoking. It's true and it sounds easy enough but it's actually super difficult. I quit smoking. It took 11 attempts and I needed a dedicated mental framework which I found in the book The Easy Way to Quit Smoking which I highly recommend. Point being these people are going to need dedicated help to dig into why they have these habits and education to teach them how to cook and eat healthy neither of which are cheap either.

Are you implying that running shoes, a bike, and/or a gym membership are a replacement for bariatric surgery? Will you suggest salads as well next?

The magnitude of the obesity epidemic should really give people more pause when imagining simple fixes like this. It's becoming more and more clear that this is not simply a problem of lifestyle, but very likely environmental factors at least as problematic as leaded gasoline was on IQs.

20 minutes of running is negated by a single cookie. Exercise alone is an exceptionally difficult way to lose weight and telling people to just exercise more is not a systemic solution.

I wouldn't be surprised if people are overeating by 1k calories/day. It takes a substantial daily gym commitment to burn that much, you're better off eating better in the first place (which unfortunately can be easier said than done)

Exercise is way less important than diet for weight loss, and eating less is free.

The surgery, if done right, makes it hard to impossible for the person to ingest too much food. Results can inverse if the person keeps trying to increase their portions with time, and they can’t get a second surgery, but if someone is committed, the surgery can be a stepping stone for them to fix their eating problem. That said, the reason some overeat is often depression and the lack of energy that comes from not being able to eat as much leads to worsening mental health. If you don’t know how to adjust your diet for a smaller stomach (more proteins and filling food, less carbs) the mental health issues grow worse.

The AAP advocates for 60 minutes of physical activity daily. This is old news.

From 2020, "A new AAP clinical report aims to give clinicians guidance to help patients achieve physical activity levels for improved health...

...Strong evidence shows that physical activity improves body composition, decreases cardiovascular disease risk and is a preferred treatment for fatty liver disease and prediabetes. Additionally, research shows benefits in children with ADHD and depression.

When it comes to health promotion, regular physical activity assessment and counseling can help improve gross motor development and physical literacy, academic performance, sleep and behavior, while it reduces teen risk-taking behaviors and helps prevent obesity and other chronic diseases. The benefits and value of physical activity extend to all children, including those with special health care needs."

Source: https://publications.aap.org/aapnews/news/12302

What would you believe they should recommend instead?

Are you saying that there are not supermarkets with basic wholesome ingredients from which to make healthy meals in the United States? That you were unable to buy grass-fed organic beef, pasture raised chicken, and organic vegetables and fruits? Where did you find this wasteland in the US? I have yet to see one that cannot provide these basic ingredients.

Human body is built to be economical. If you don't use muscles regularly, they degenerate to the size sufficient for your normal load.

If you want to look athletic, the only way is to be athletic, that is, spend significant effort working your muscles, proving to your body that you actually have a use for them. For most people it means a gym, or a barbell at home, or some kind of athletic sports, several days a week.

If, on top of that, you don't want a belly (which is a normal way for the body to store some energy reserve near the center of gravity), you also need to limit your intake of carbs.

You will look spindly if you remain sedentary and eat fewer calories, yes. Importantly, you can eat the same amount of food if you eat things that aren't laced with sugar and have higher fiber content. This is a good rule of thumb for cutting the excess calories when you're first starting out.

The trick is to metabolize the food you eat. You do that with exercise, primarily cardio. Then your body's new homeostatic program also involves "supporting the frame of the body during physical movement" and you begin to develop some muscle, preventing the emaciated look.

You make it sound like not being overweight is just about looks, but there are really important health reasons too.

Body positivity will go down as one of the most destructive marketing campaigns of all time. It helped lock in big food and big pharma revenues and avoid scrutiny at the expense of people's health and amplified healthcare costs for everyone.

I think the problem with “food deserts” (kind of dramatic term but that’s probably the point) is that they are significant hurdles for the working class (maybe they can order, but can they justify that in their budget?) and serious issues for the very poor who don’t have transportation.

The important question is how many impoverished or nearly impoverished people live in a food desert.

Respectfully, I think you might have gotten used to the sas state America has ended up in. I'm in a reasonably sized city, and have fresh groceries less than half a mile away. My parents live in a suburban, approaching rural area - and have multiple grocery stores within a mile. Hell, I had fresh produce within a mile in a very small town in Alberta, at both apartments I lived in.

I can see the argument if most people were actually living someplace rural - but they aren't. Living in a city that's also a food desert sounds like it misses the point of what a city is for, to be honest.

Great discussion.