"How a ‘fatally, tragically flawed’ paradigm has derailed the science of obesity"

Not sure if this behind a paywall but Ii thought it was interesting.


I scanned ahead and was not surprised to see Ludwig - his Always Hungry book was pretty eye-opening, especially with regard to “set-points” in the brain.

Then scanning on, not surprised to see leptin mentioned, and wondering why Aronne (in nyc) wasn’t mentioned by name - but clicking over to the article, Aronne is the second name after Ludwig. He has a thriving practice here, but it’s not cheap.

There’s so much tied up in this topic that falls across many fields. Fat-blaming being easier than finding a scientific reason. Diet-industrial complex. Pharma & insurance. And so on.


Thanks for that link to the journal article! I don’t know how I ended up on the email list for the original post, but I like that they provide links to the original research.

Low carb has been annoying but worked well for me, in terms of weight and blood sugar. OTOH, I’m about to eat my weight in bacon, and I’m not sure I’m all that healthy!


The bacon and coffee diet, sadly, doesn’t get enough praise these days.


while there are medical “disorders/causes” for obesity, common sense and observation says that it not, as the article would have, the “root cause”

look at the fast food chains:
!two for $1
!buy two get five free
on and on

go to a grocery store.
observe what mothers with chunky toddlers in tow are putting in their grocery cart:
pre-sweetened breakfast cereals
sugar coated “anythings”
microwave fatbombs
shopping weekly(?) with 10 frozen pizzas in the cart
preprepped heat/nuke & eat ‘entrees’ - and not the Lean Cuisine kind
HungryMan Family Size
no fruits
no fresh vegetables.

so, sorry - but I ain’t buying the ‘diet has nothing to do with it’ idea.

I didn’t see that part. In my experience, science is rarely that black and white. Was that in the Stat article or one of the links?

"common sense and observation says that it not, as the article would have, the “root cause”

I’m not sure I understand, but I don’t think I saw the part about a defined root cause either. Again, the Stat article or one of the links?

What I like is the idea that perhaps we don’t yet understand the root cause as well as some think.

Anecdotal of course, but I was so crazy about my oldest child’s “diet” as an infant and toddler. The whole crazy making “What To Expect When You’re Expecting” stuff of the late 80’s. Breast fed for12 + months, home made baby food, if there were grains, they were whole grains. Drove sitters nuts. Second child comes along and I was like whatever. Carnation Instant breakfast in a sippi cup.

No prepared food, no white bread, no white anything (haha) in the house. They discovered the boxed mac and cheese and the like when old enough to eat at friends.

(Mild exaggerations for effect, but absolutely true about the mac and cheese.)

Guess how that turned out.

ETA I found the "disorder " part. But I’m pretty sure a disorder is not defined as a root cause; then it would be called a disease, right? I think that’s what separates psychiatry from neurology, and the insurance coverage coverage to go with.

The article reads

“Obesity is not an energy balance disorder, a hormonal or constitutional disorder, a dysregulation of fat storage and metabolism, a disorder of fuel-partitioning. Because these hormonal responses are dominated by the insulin signaling system, which in turn responds primarily (although not entirely) to the carbohydrate content of the diet, this thinking is now known as the carbohydrate-insulin model.”

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Those made me laugh even with the burrito dangling out of my mouth like a cigarette.


Not sure I understand - are you saying common sense and observation trumps decades of medical research on specific hormonal (and in cases genetic) causes and/or predispositions?

Societal bias is one of many reasons the diet industrial complex thrives, and legitimate medical research stays in the realm of journals and harder-to follow (vs trendy diets) meal plan books like Ludwig’s.

The science does not advocate going to fast food chains or eating junk from grocery stores.

For example Ludwig’s book or anything by other names on that list usually eliminate processed and junk foods and simple carbs from the diet first, and point people in the direction of low glycemic (low carb) food plans for a period of time - to adjust the hormones.

But there is also significant research at this point showing that it’s not as simple as “fat people eat badly, that’s why they’re fat” and also that it’s much harder for overweight people not only to lose weight in the first place - even with healthy eating and exercise - but also to permanently keep off weight they have lost (some might say impossible - because of set-points in the brain, which cause the body to eventually swing back to previous weight equilibrium).

The discussion of what food is most easily accessible and cheap is a separate public policy one, not to do with the science - nor a reason to dismiss it. There are many reasons, behavioral and psychological included. Lots of research and discussion on different aspects. This is just one.