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The Latest Trend is Fasting: What say you?
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I can't help but think we mean the same thing and are just expressing it differently. I may also have misinterpreted your first reaction. My point is simply that CICO, as expressed by de Lavoisier in his apocryphal saying "rien ne se perd, rien ne se crée, tout se transforme" remains completely intact. All the rest of the complicating factors (feedback loops, hormones, sleep, water, whatever) are simply side shows that have minor effects here and there but do not change the fundamental fact expressed by CICO.neanderthin wrote: »BartBVanBockstaele wrote: »
No thinking scientist would deny the possibility of that. More scientists would ask for verifiable evidence of that. There is, but it is scant and very unreliable. There are good reasons for that, but that does not by magic validate the claims. We should be open-minded enough to accept the possibility, but not so naive as to accept the claims as facts, just because they are hard to prove.neanderthin wrote: »BartBVanBockstaele wrote: »
I concur. These erroneous claims are all over the place, sometimes even made by people who *know* that what they are saying is nonsense, for example:neanderthin wrote: »the_real_me_lissa wrote: »Fasting? Oh, you mean privileged starving!!
Way over hyped & totally unnecessary!!
K...
Well I'm just going to stick with it since it was prescribed by my world renowned neurologist, and I find it much more pleasant than eating multiple times a day...
I'm not even doing this for weight loss, I've been in maintenance doing IF for nearly a year and I have no interest in ever going back.
Besides, I don't think anyone has said it's "necessary," just that some of us prefer it.
I don't get the judgement.
I think most of the confusion and not just in fasting but in general is the misunderstanding of energy expenditure where some people seem to think it challenges CICO, which it does not, it's just not well understood, and basically devolves from there.
"Allegedly, to avoid weight gain we would simply have to burn the same number of calories as we eat. The theory sounds logical. Unfortunately, it is untrue."
https://www.youtube.com/watch?v=DboTyNu-FLk&t=485s
"fat accumulation equals sort-of calories in minus calories out and they say "well that's always true because if you look at it from a physics perspective, that is always true but the problem is that's physics and we are dealing with human physiology and it really has nothing to do with each other."https://www.youtube.com/watch?v=DboTyNu-FLk&t=510s
Jason Fung is particularly shocking, because he claims that CICO is untrue and then turns around to recommend fasting, which is about as extreme CICO as one can go.
Well, not so fast. Calories in has an impact (effect) on calories out and calories out will also have an effect on calories in.
And in the end, the message is always the same: CICO is where it's at. All these secondary effects can do is change energy consumption a little bit. Nothing more. Stop feeding a living system, and that living system will die. Before it dies, it will lose weight. Feed a living system less than it needs, and it will die, it will just die a little slower, again while losing weight. Feed it more than it needs and it will again die a little faster. this time while gaining weight.
And of course, all living systems eventually die, regardless of what we feed them. The point is simply to find the optimal point, the sweet point, the bliss point, it does not matter how we call it. We usually define it as the place where optimal weight is maintained, even if that is more of a concept than a real thing.
My statement takes CICO into account, I'm not sure what you mean by verifiable evidence, it's well understood and documented.
A direct example would be the calorie content, macronutrient composition, nutrient absorption and digestion which effects our energy expenditure expressed by changes in the thermic effect of food (TEF).
An Indirect effect would be when we either undereat or overeat, and in the bodies attempt for find stasis will effect NEAT (non-exercise energy thermogenesis)
None of this violates the 1st law of thermodynamics.
In my own personal case, such a complicating factor would be a malfunctioning thyroid. I get no treatment for it. The result is that losing weight is a little harder, nothing more. It does not stop weight loss. It does not cause weight gain. The fundamentals do not change. I compare it to slow driving a car. Sure, that enables the car to travel a little further, but it is not going to stop energy consumption by that car. The fundamentals do not change.
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BartBVanBockstaele wrote: »
I can't help but think we mean the same thing and are just expressing it differently. I may also have misinterpreted your first reaction. My point is simply that CICO, as expressed by de Lavoisier in his apocryphal saying "rien ne se perd, rien ne se crée, tout se transforme" remains completely intact. All the rest of the complicating factors (feedback loops, hormones, sleep, water, whatever) are simply side shows that have minor effects here and there but do not change the fundamental fact expressed by CICO.neanderthin wrote: »BartBVanBockstaele wrote: »
No thinking scientist would deny the possibility of that. More scientists would ask for verifiable evidence of that. There is, but it is scant and very unreliable. There are good reasons for that, but that does not by magic validate the claims. We should be open-minded enough to accept the possibility, but not so naive as to accept the claims as facts, just because they are hard to prove.neanderthin wrote: »BartBVanBockstaele wrote: »
I concur. These erroneous claims are all over the place, sometimes even made by people who *know* that what they are saying is nonsense, for example:neanderthin wrote: »the_real_me_lissa wrote: »Fasting? Oh, you mean privileged starving!!
Way over hyped & totally unnecessary!!
K...
Well I'm just going to stick with it since it was prescribed by my world renowned neurologist, and I find it much more pleasant than eating multiple times a day...
I'm not even doing this for weight loss, I've been in maintenance doing IF for nearly a year and I have no interest in ever going back.
Besides, I don't think anyone has said it's "necessary," just that some of us prefer it.
I don't get the judgement.
I think most of the confusion and not just in fasting but in general is the misunderstanding of energy expenditure where some people seem to think it challenges CICO, which it does not, it's just not well understood, and basically devolves from there.
"Allegedly, to avoid weight gain we would simply have to burn the same number of calories as we eat. The theory sounds logical. Unfortunately, it is untrue."https://www.youtube.com/watch?v=DboTyNu-FLk&t=485s
"fat accumulation equals sort-of calories in minus calories out and they say "well that's always true because if you look at it from a physics perspective, that is always true but the problem is that's physics and we are dealing with human physiology and it really has nothing to do with each other."https://www.youtube.com/watch?v=DboTyNu-FLk&t=510s
Jason Fung is particularly shocking, because he claims that CICO is untrue and then turns around to recommend fasting, which is about as extreme CICO as one can go.
Well, not so fast. Calories in has an impact (effect) on calories out and calories out will also have an effect on calories in.
And in the end, the message is always the same: CICO is where it's at. All these secondary effects can do is change energy consumption a little bit. Nothing more. Stop feeding a living system, and that living system will die. Before it dies, it will lose weight. Feed a living system less than it needs, and it will die, it will just die a little slower, again while losing weight. Feed it more than it needs and it will again die a little faster. this time while gaining weight.
And of course, all living systems eventually die, regardless of what we feed them. The point is simply to find the optimal point, the sweet point, the bliss point, it does not matter how we call it. We usually define it as the place where optimal weight is maintained, even if that is more of a concept than a real thing.
My statement takes CICO into account, I'm not sure what you mean by verifiable evidence, it's well understood and documented.
A direct example would be the calorie content, macronutrient composition, nutrient absorption and digestion which effects our energy expenditure expressed by changes in the thermic effect of food (TEF).
An Indirect effect would be when we either undereat or overeat, and in the bodies attempt for find stasis will effect NEAT (non-exercise energy thermogenesis)
None of this violates the 1st law of thermodynamics.
In my own personal case, such an effect would be a malfunctioning thyroid. I get no treatment for it. The result is that losing weight is a little harder, nothing more. It does not stop weight loss. It does not cause weight gain. The fundamentals do not change. I compare it to slow driving a car. Sure, that enables the car to travel a little further, but it is not going to stop energy consumption by that car. The fundamentals do not change.
An endocrinologist might have something to say about "simply side shows that have minor effects here and there"0 -
Protein is often offered as an example of this. Strangely, very few people actually make the calculation. In the case of protein, we extract about 70% usable energy from protein. Most dietitians will tell us that we *need* on average 50 g of protein a day. It is much higher for sugar, about 98% (number from memory). That means that we extract about 56 fewer calories from 50 grams of protein than from 50 grams of white, refined, pure sugar. In comparison to the average 2000 kcal we need a day, that is almost negligible. When we are talking averages, these differences are merely rounding errors. They are measurable, demonstrable, but so low that they don't matter.neanderthin wrote: »changes in the thermic effect of food (TEF).
And then, think about fibre, which is almost completely unusable as a source of energy for humans (obviously, the same is *not* true for the bacteria that live in us, but still). The limiting factor here is again, that there is a maximum amount of fibre most people can handle. Before starting my current strict diet, I was regularly consuming 100 g or more. Now it is usually between 40 and 50 g. Is it important? Taken over a year or so, sure, taken over a day, a week or even a month, I am unaware of any scale that is able to measure it. While that is only important to me, I am using a mechanical medical scale, I have data spanning the last four years (less one month) and I see no effect. It does not mean the effect is not there, only that it is negligible in comparison with the 60 kg I have lost.0 -
neanderthin wrote: »BartBVanBockstaele wrote: »
I can't help but think we mean the same thing and are just expressing it differently. I may also have misinterpreted your first reaction. My point is simply that CICO, as expressed by de Lavoisier in his apocryphal saying "rien ne se perd, rien ne se crée, tout se transforme" remains completely intact. All the rest of the complicating factors (feedback loops, hormones, sleep, water, whatever) are simply side shows that have minor effects here and there but do not change the fundamental fact expressed by CICO.neanderthin wrote: »BartBVanBockstaele wrote: »
No thinking scientist would deny the possibility of that. More scientists would ask for verifiable evidence of that. There is, but it is scant and very unreliable. There are good reasons for that, but that does not by magic validate the claims. We should be open-minded enough to accept the possibility, but not so naive as to accept the claims as facts, just because they are hard to prove.neanderthin wrote: »BartBVanBockstaele wrote: »
I concur. These erroneous claims are all over the place, sometimes even made by people who *know* that what they are saying is nonsense, for example:neanderthin wrote: »the_real_me_lissa wrote: »Fasting? Oh, you mean privileged starving!!
Way over hyped & totally unnecessary!!
K...
Well I'm just going to stick with it since it was prescribed by my world renowned neurologist, and I find it much more pleasant than eating multiple times a day...
I'm not even doing this for weight loss, I've been in maintenance doing IF for nearly a year and I have no interest in ever going back.
Besides, I don't think anyone has said it's "necessary," just that some of us prefer it.
I don't get the judgement.
I think most of the confusion and not just in fasting but in general is the misunderstanding of energy expenditure where some people seem to think it challenges CICO, which it does not, it's just not well understood, and basically devolves from there.
"Allegedly, to avoid weight gain we would simply have to burn the same number of calories as we eat. The theory sounds logical. Unfortunately, it is untrue."https://www.youtube.com/watch?v=DboTyNu-FLk&t=485s
"fat accumulation equals sort-of calories in minus calories out and they say "well that's always true because if you look at it from a physics perspective, that is always true but the problem is that's physics and we are dealing with human physiology and it really has nothing to do with each other."https://www.youtube.com/watch?v=DboTyNu-FLk&t=510s
Jason Fung is particularly shocking, because he claims that CICO is untrue and then turns around to recommend fasting, which is about as extreme CICO as one can go.
Well, not so fast. Calories in has an impact (effect) on calories out and calories out will also have an effect on calories in.
And in the end, the message is always the same: CICO is where it's at. All these secondary effects can do is change energy consumption a little bit. Nothing more. Stop feeding a living system, and that living system will die. Before it dies, it will lose weight. Feed a living system less than it needs, and it will die, it will just die a little slower, again while losing weight. Feed it more than it needs and it will again die a little faster. this time while gaining weight.
And of course, all living systems eventually die, regardless of what we feed them. The point is simply to find the optimal point, the sweet point, the bliss point, it does not matter how we call it. We usually define it as the place where optimal weight is maintained, even if that is more of a concept than a real thing.
My statement takes CICO into account, I'm not sure what you mean by verifiable evidence, it's well understood and documented.
A direct example would be the calorie content, macronutrient composition, nutrient absorption and digestion which effects our energy expenditure expressed by changes in the thermic effect of food (TEF).
An Indirect effect would be when we either undereat or overeat, and in the bodies attempt for find stasis will effect NEAT (non-exercise energy thermogenesis)
None of this violates the 1st law of thermodynamics.
In my own personal case, such an effect would be a malfunctioning thyroid. I get no treatment for it. The result is that losing weight is a little harder, nothing more. It does not stop weight loss. It does not cause weight gain. The fundamentals do not change. I compare it to slow driving a car. Sure, that enables the car to travel a little further, but it is not going to stop energy consumption by that car. The fundamentals do not change.
An endocrinologist might have something to say about "simply side shows that have minor effects here and there"
I assume we are talking about weight loss and energy consumption, not general health.
And yes, in that context, an endocrinologist would say the exact same thing. That is why I do not get treatment for my thyroid. Healthwise, it would depend more on the individual insights of the endocrinologist. There are some that think that not treating might cause some increased health risks. Others disagree with that viewpoint. We simply do not know enough yet, but then, this is a site about weight management, not general and specialty healthcare.0 -
Like I said, energy expenditure is not well understood. Cheers.1
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Actually, it is astonishingly well-understood. We just don't know it down to the personal level because there are some ethics around carving up and experimenting in individual patients. That said, it is unimportant. What is important is that life's processes need energy, i.e. CICO. All the rest are just skirmishes on the sidelines.neanderthin wrote: »Like I said, energy expenditure is not well understood. Cheers.
What would really be interesting, fascinating and science-changing would be that someone produces verifiable cases of individuals who gain fat weight while living on energy deficient diets. That is impossible, but it is what some people are claiming, and while I and every scientist with half a functioning brain cell disagree, wouldn't it be absolutely fascinating and thrilling if such individuals could be produced? It would overthrow everything we know about reality, and essentially send us back to the drawing board.
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I'm sure one day I'll have all the answers but until then I'll continue to ask questions. Cheers.1
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I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.1
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I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.
Same. I also don't find it "extreme" at all. I find it very comfortable and way more sustainable *for me*.
It's not for everyone, because no one way of eating is for everyone. But I seriously wouldn't go back to multiple meals a day if you paid me.
I eat exactly as often as I feel like eating. If I wanted to eat more often, I would.
So yeah, for some of us, fasting isn't extreme, it's just easy.3 -
I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.
Im glad it works for you and I like the way you post clarified that that is the case for you and not for everyone.
But I cant see the point of trying things for sake of trying them - if what anyone is doing now works for them why try something else?
Or if it aint broke, don't fix it.
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Perhaps to find something that works better, just in case there are suspicions that what seems to work is just a placebo effect?paperpudding wrote: »I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.
Im glad it works for you and I like the way you post clarified that that is the case for you and not for everyone.
But I cant see the point of trying things for sake of trying them - if what anyone is doing now works for them why try something else?
Or if it aint broke, don't fix it.
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paperpudding wrote: »I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.
Im glad it works for you and I like the way you post clarified that that is the case for you and not for everyone.
But I cant see the point of trying things for sake of trying them - if what anyone is doing now works for them why try something else?
Or if it aint broke, don't fix it.
I’m not talking completely reinventing the wheel. I’m just saying I like to tweak things up here and there. Have a plateau or a stall or just feel like things could be better….maybe try some other methods mixed in. I wouldn’t do it just for the sake of doing it personally. If it’s working and you’re feeling good doing it, switching is kind of pointless imo.1 -
I have currently started I am at day 4 and have lost 800grams. The key is for me when I BREAK my fast I make sure I am including good fats, fiber and protein so I generally make a protein smoothie which includes chia seeds, frozen banana, organic greek yoghurt , protein powder. I walk 10,000 steps a day. Drink lots of water and green tea inbetween meals , I dont even get hungry for snacks. I found a good resource on youtube I have been learning from is Autumn Bates, a nutrionist. Good luck.1
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BartBVanBockstaele wrote: »
Perhaps to find something that works better, just in case there are suspicions that what seems to work is just a placebo effect?paperpudding wrote: »I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.
Im glad it works for you and I like the way you post clarified that that is the case for you and not for everyone.
But I cant see the point of trying things for sake of trying them - if what anyone is doing now works for them why try something else?
Or if it aint broke, don't fix it.
if one is losing/maintaining weight as expected and is happy with ones way of eating how could that be a placebo effect??
it isnt 'seeming' to work - it is working by both objective data ( ones weight) and subjectively whether it is how one wants to eat.
Nothing to have suspicions about.
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paperpudding wrote: »I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.
Im glad it works for you and I like the way you post clarified that that is the case for you and not for everyone.
But I cant see the point of trying things for sake of trying them - if what anyone is doing now works for them why try something else?
Or if it aint broke, don't fix it.
I’m not talking completely reinventing the wheel. I’m just saying I like to tweak things up here and there. Have a plateau or a stall or just feel like things could be better….maybe try some other methods mixed in. I wouldn’t do it just for the sake of doing it personally. If it’s working and you’re feeling good doing it, switching is kind of pointless imo.
oK, I guess we are in agreement really - you individually like to tweak things here and there - fair enough that is your style.
and you and I both seem to agree there is no point in everyone changing what is working just because
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That is a very common question/statement.paperpudding wrote: »BartBVanBockstaele wrote: »
Perhaps to find something that works better, just in case there are suspicions that what seems to work is just a placebo effect?paperpudding wrote: »I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.
Im glad it works for you and I like the way you post clarified that that is the case for you and not for everyone.
But I cant see the point of trying things for sake of trying them - if what anyone is doing now works for them why try something else?
Or if it aint broke, don't fix it.
if one is losing/maintaining weight as expected and is happy with ones way of eating how could that be a placebo effect??
it isnt 'seeming' to work - it is working by both objective data ( ones weight) and subjectively whether it is how one wants to eat.
Nothing to have suspicions about.
It is one I have been the victim of myself. When I was 60 kg heavier than now, I managed to lose about 40 kg but it was absolute torture (due to excessive hunger, pain, nausea and vomiting) and I was unable to continue as a result. In fact, it was so terrible that when a friend asked me what I really wanted, I told her I wanted euthanasia. I obviously didn't get it, since I am still here whining about it.
I was quickly regaining weight when it was suspected I had diabetes. I was prescribed metformin, a common first-line medication for the condition. It so happened that I discovered that while I was still hungry (and remain to this day), the pain, the nausea and the vomiting disappeared and I was able to restart my weight loss journey (which is still continuing as of this writing).
My understandable conclusion, despite the fact that I knew metformin was not known for causing this effect and no examples can be found in the literature, was that this was an uncommon/rare side effect of metformin. Who was I to doubt that? After all, I was losing weight in a way I had been unable to do before. I was ecstatic and was singing the praises of metformin to all who wanted and did not want to hear it.
But then, it was decided to stop the metformin because there were good reasons to think I did not have diabetes. I was terrified, but I complied. And what happened? Nothing. The hunger remained, but the pain, the nausea and the vomiting did not return, and I was able continue my weight loss journey.
In short, something happened to make the less-torturous weight loss possible, but it wasn't metformin. There were two possible known explanations remaining: a genuine placebo effect and the fact that the diabetes hypothesis (which turned out to be wrong) had led me to follow not a low, but lower, carb diet. While it is impossible to prove either, the lower carb diet is the most likely explanation because placebo effects are not known for lasting years on end and I haven't seen an endocrinologist in a year or two by now.
Is the lower carb diet the cause? Also uncertain, since lower carb diets are not know for having such dramatic effects either and I am unwilling to test the hypothesis by reintroducing my beloved self-baked bread and short-grain white rice. I might try it in the future but for now, the very idea terrifies me to no end and there is no way I am going to "tempt fate".
In short, the explanation of a placebo effect, while less likely after four years, remains possible.
All my story shows is that medicine can be unpredictable and has lots of uncertain areas.
These are also the areas where quacks thrive. A well-known example can be found in the US Senate hearing where Dr. Oz was asked to testify. See videos below. The point is that while results can be real, they are not necessarily caused by the obvious explanation. It is called the "post hoc ergo propter hoc" fallacy (after this, therefore because of this). It is why randomised-controlled trials with large-enough groups are so important and it is also why the results of a single trial should never be taken at face value.
Videos:
https://www.youtube.com/watch?v=kgApDJwc4Ow
The complete hearing is here:
https://www.commerce.senate.gov/2014/6/commerce-committee-announces-subcommittee-hearing-on-false-and-deceptive-marketing-of-weight-loss-products
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BartBVanBockstaele wrote: »
That is a very common question/statement.paperpudding wrote: »BartBVanBockstaele wrote: »
Perhaps to find something that works better, just in case there are suspicions that what seems to work is just a placebo effect?paperpudding wrote: »I don’t know anything about it being “new”. I’ve had great success with it. I feel great when I’m consistently doing it. Is it for everyone? No, I’m not ignorant or smug enough to say that. I don’t mock things that others might find useful though either. I’m an adult. I know there is more than 1 correct way. As long as it’s not coherently unhealthy, try it! Now that I’m close enough to goal I have fun giving things a try here and there. Oh, and the research on it is pretty hopeful. Also the biggest anecdotal piece of evidence of all….. works for me.
Im glad it works for you and I like the way you post clarified that that is the case for you and not for everyone.
But I cant see the point of trying things for sake of trying them - if what anyone is doing now works for them why try something else?
Or if it aint broke, don't fix it.
if one is losing/maintaining weight as expected and is happy with ones way of eating how could that be a placebo effect??
it isnt 'seeming' to work - it is working by both objective data ( ones weight) and subjectively whether it is how one wants to eat.
Nothing to have suspicions about.
It is one I have been the victim of myself. When I was 60 kg heavier than now, I managed to lose about 40 kg but it was absolute torture (due to excessive hunger, pain, nausea and vomiting) and I was unable to continue as a result. In fact, it was so terrible that when a friend asked me what I really wanted, I told her I wanted euthanasia. I obviously didn't get it, since I am still here whining about it.
I was quickly regaining weight when it was suspected I had diabetes. I was prescribed metformin, a common first-line medication for the condition. It so happened that I discovered that while I was still hungry (and remain to this day), the pain, the nausea and the vomiting disappeared and I was able to restart my weight loss journey (which is still continuing as of this writing).
My understandable conclusion, despite the fact that I knew metformin was not known for causing this effect and no examples can be found in the literature, was that this was an uncommon/rare side effect of metformin. Who was I to doubt that? After all, I was losing weight in a way I had been unable to do before. I was ecstatic and was singing the praises of metformin to all who wanted and did not want to hear it.
But then, it was decided to stop the metformin because there were good reasons to think I did not have diabetes. I was terrified, but I complied. And what happened? Nothing. The hunger remained, but the pain, the nausea and the vomiting did not return, and I was able continue my weight loss journey.
In short, something happened to make the less-torturous weight loss possible, but it wasn't metformin. There were two possible known explanations remaining: a genuine placebo effect and the fact that the diabetes hypothesis (which turned out to be wrong) had led me to follow not a low, but lower, carb diet. While it is impossible to prove either, the lower carb diet is the most likely explanation because placebo effects are not known for lasting years on end and I haven't seen an endocrinologist in a year or two by now.
Is the lower carb diet the cause? Also uncertain, since lower carb diets are not know for having such dramatic effects either and I am unwilling to test the hypothesis by reintroducing my beloved self-baked bread and short-grain white rice. I might try it in the future but for now, the very idea terrifies me to no end and there is no way I am going to "tempt fate".
In short, the explanation of a placebo effect, while less likely after four years, remains possible.
All my story shows is that medicine can be unpredictable and has lots of uncertain areas.
(snip video) and quack comments
That's a completely different scenario. We're talking about weight loss, measured on the scale. If scale weight is dropping at a sensible and satisfying rate, and the person losing that weight feels good/happy with their eating . . . but that's a placebo effect, why in the heck would they even care that it's a placebo effect?
(P.S. I don't think it would be a placebo effect, though I know there's some provocative early research about mindset having measurable physical effects.)
Sure, some of the other effects imputed to special ways of eating have more potential to involve placebo effects - energy level, satiation, and that sort of thing. (Special ways of eating could be anything: Fasting as in this thread, unusual macros like low carb or keto, vegan/vegetarianism, etc. ) And I'm not claiming definitively that objective physical benefits of those ways of eating don't exist. I'm just saying that mostly-subjective outcomes like satiation or energy are more subject to placebo effect. But who cares, in such cases? It's real to the subject.
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Sure. I will not disagree with that. I would just add that these benefits are likely not direct benefits, but the result of behavioural changes that were made possible/easier thanks to these effects. It is the same as when dietitians claim that "stress causes weight gain". It does not. What stress, which is a very subjective factor, does, is to encourage behaviour that causes weight gain a.k.a. eating. That is not a trivial distinction.And I'm not claiming definitively that objective physical benefits of those ways of eating don't exist. I'm just saying that mostly-subjective outcomes like satiation or energy are more subject to placebo effect.
In fact, it is why I was (and am) so mad at the Dutch guidelines to treat obesity in adults and children. This is a 188 page document and the word "honger" (hunger) occurs a single time in this document (https://www.nhg.org/sites/default/files/content/nhg_org/uploads/obesitas-diagnostiek-en-behandeling-van-obesitas_0.pdf). For contrast, the word "gedragsverandering" (behaviour modification) occurs 30 times and "eetgedrag" (eating behaviour) 22 times. My point is that one of the most important subjective drivers and possibly the single most important and irresistable driver of eating behaviour is barely even acknowledged.
. "Real to me" is a one of the most dangerous statements there are and it is so easy to get taken by it, which is why I cited my own example: as I can safely do that without insulting anybody. It is one of the causes of religious wars, it destroys the lives of people and it enriches quacks. It is one of the reasons science is so difficult, and why it advances so slowly. Remember"the four humours" or bloodletting? It is why randomised-controlled trials, done by several different teams, preferrably on different continents are so important for science. They are far from perfect, but they are, at this stage in our evolution, the best (or least bad) we have.But who cares, in such cases? It's real to the subject.
That research exists, but I think we have largely moved on from there. It is now generally recognised that these effects are not very strong, not long-lived and unpredictable. That does not necessarily mean they are not real, it just means that they are unusable right now. They might become usable in the future, but as we know, we live in the present, not in a future that may or may not happen.(P.S. I don't think it would be a placebo effect, though I know there's some provocative early research about mindset having measurable physical effects.)
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Seems semantics and mainsplaining to me.
Objectively weight is changing as per scale readings, person is happy with their eating style - there is no placebo in that.
And no point in changing something that isn't broken.
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There is some semantics in this. I am trying to be as precise as I can, but I am certainly not claiming any degree of perfection here. If you study non-specific effects, which include both placebo and nocebo effects, you will see that the field is vast and has its own specialists studying it. To make it worse, much of it is unknown. That is why randomised-controlled trials are the gold standard right now: they are an imperfect, but very good attempt at eliminating artifacts caused by such imperfections.paperpudding wrote: »Seems semantics and mainsplaining to me.
Objectively weight is changing as per scale readings, person is happy with their eating style - there is no placebo in that.
And no point in changing something that isn't broken.
That said, the semantics are important. If people talking about something are using the same vocabulary to mean different things, chaos ensues, and I happen to be confronted with that situation on an almost daily basis. To make things worse, the current climate where privacy is more important than health can create situations that are to the detriment of the patient. It does not happen all that often, but a patient only needs to be a victim once to understand that well-intentioned protections can lead to very unfortunate outcomes.
As for the scale, I am myself a big fan of the scale. I learned the hard way that most electronic scales have rather large error margins. That is fine, but what really frustrated me was when I stood on the scale, weighed myself, and then weighed myself again after a bathroom visit to discover I had gained a kg. Low accuracy is one thing, but this was ridiculous. So, I bought a mechanical medical scale and that solved the problem.
That said, the water problem remains. Someone who has been practicing frequent weighing knows that, but people who start are very often discouraged by it and give up. I think that those of us who do have experience, should caution newcomers for that phenomenon. Don't forget that many sources are using these phenomena to make promises that are beyond ridiculous.
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