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The current title “How aging stem cells fuel visceral fat gain in middle age” suggests that existing stem cells simply ramp up fat production as they age.

Single-cell RNA sequencing of APCs then identified a new committed preadipocyte population that is age enriched (CP-A), both in mice and humans. CP-As displayed high proliferation and differentiation capacities, both in vitro and in vivo.

It should read more like "aging triggers emergence of a specific stem cell type (APCs) which drives visceral fat expansion"

A possible solution would be some kind of viral therapy - a custom virus to target adipocytes. Similarly how it's done [1] to some cancer cells.

[1] https://en.m.wikipedia.org/wiki/Oncolytic_virus

We already have the tech to delete adipocytes -- it is call liposuction. Reducing the number of adipocytes turns out to have adverse effects on metabolic health.

IIRC, liposuction, just like every invasive surgery increases risks and complications significantly.

And liposuction doesn't work for visceral fat, which is far worse than subQ fat

OK, but my point is that even if we could avoid surgical complications completely, significantly reducing the number of adipocytes in the body would still be a bad idea (in almost everyone).

That kind of virus would make me very nervous, considering many organs, included the brain, have adipocytes in them.

Or, you know, drink a beer or two less.

Bwa ha ha ha ha, no.

Another solution is to accept our bodies as they are and not to promote unrealistic beauty standards in our media

Subjective beauty standards aside, there is objective health "standard", obesity is a source of so many health problems, for the individual and society.

Staying in good shape also has major effects on your mentality, energy levels, and much more. It just turns out that as you age you've really gotta start shifting your diet hard from what it was like when you were younger.

However staying in shape by becoming a gym bro spending hours a week lifting weights and chugging protein powder also has major effects on your mentality, and those aren't good effects.

What effects do you think lifting weights regularly has on one's mentality, and why don't you think that those are not good effects?

Obesity isn't the thing you have just before you become a "gym bro". There's a chasm separating them.

Sure, and I maintain with healthy weight just on the normal walks around the village (although I did go slightly into the "overweight" category after one Christmas

The point is that it's very easy to go too far in the opposite direction, from being overweight to being a gym addict.

There's a huge difference between accepting some natural amount of body fat, and also realizing that there is an absolutely astronomical obesity epidemic in most of the industrialized world. Accepting obesity is not a good idea - it's bad for physical health, it's bad for mental health, it's bad for the economy. It's just bad and something needs to be done about it.

There are few things more damaging in life than being overweight - as can be clearly seen in shorter lifespans. Obesity is roughly equal to smoking.

They are not pushed by the media though. Men and women are attracted to what they are attracted to. We instinctively know if someone is attractive to us. Its easy to say person A is more attractive than person B. Thinner and more in shape people are more attractive than obese people. This is just a fact of life, no one is to blame for it.

"This is just a fact of life, no one is to blame for it."

Please remember that your culture affects your idea of normal immensley. There are large periods of history where europeans considered being overweight attractive, where being extremely pale was attractive rather than tan etc. Some cultures have even more extreme versions of this (foot binding, neck lengthening rings etc). Those people probably thought that their idea of beuaty was "just a fact of life" too.

I can almost guarantee you that any of those cultures (foot binding, neck lengthening rings etc) would absolutely agree that the hot girl at the club in NYC with her normal size neck and feet is indeed hot.

I think you underestimate your cultural bias. Being physically capable may seem like an objective basis for attraction, but at various times and places in history larger people have been considered more attractive than skinnier ones, perhaps because a richer diet signifies affluence. Remember that, relatively recently, having a suntan changed its connotation away from "farmer" and toward "world traveler".

I suspect those people would be considered merely overweight today. Characters like Henry VIII were pretty rare

Standards of attractiveness vary significantly across cultures, so a simplistic biological perspective is misguided. It’s reasonable to argue that attraction is instinctive, but only if we acknowledge that our understanding of those instincts is shaped by cultural influences - including mass media.

That hot girl in the club is going to be a hot girl in the club, regardless of the club being located in New York, Tel Aviv, Dubai or Nairobi

No need to over complicate things

That’s modern globalized cultural, which doesn’t really represent the expanse of human cultural diversity, and is heavily influenced by modern social and mass media. Think instead of examples such as lip plates, extreme fattening, crossed eyes, unibrows, tooth blackening - all features considered attractive in different cultures.

Everything you have listed are niche fetishes with no widespread acceptance in society. Again, the hot girl in the club is going to be considered hot by most of the people practicing these fetishes as well.

This is akin to me saying women on average are shorter than men and you retorting with "I know a tall woman"

Those are all examples taken from actual cultures not fetishes.

Unibrow: Tajikistan Crossed eyes: ancient Mayan culture Teeth blackening: Ohaguro etc

Our modern globalized culture only gives us a tiny taste of what cultural diversity really is. That is because cultural diversity is actually erased by globalization - a process really begun by colonization, really the earliest form of globalization.

Who cares? The Mayans are dead. Civilizations rise and fall. Today we all agree what is attractive or not. The hot girl in the club is always attractive. I don’t care what the fringe likes. We don't have to celebrate or respect what other cultures found acceptable. The Aztecs sacrificed and ate children, the world was better off after they were gone. I don't have to respect their culture or what they found attractive or examine the nuances of why "actually their child sacrifices were ok"

I'm going to confidently continue to find attractive what I find attractive and 95% of the world agrees with me. I celebrate the rise of the current global culture.

I’ll leave it to you to lament the end of foot binding and blackened teeth.

My point was that culture does in fact inform our beauty standards. No reason to get defensive about it.

Sorry man, I've had DEI and empathy and "respect for other cultures" forced on me for so long that I unconsciously lash at out now. I hit the limit on it and its bled into other areas. Apologies for taking it out on you.

If anything it’s genetics at play attempting to produce the healthiest offspring.

The more there is research into how fat actually works as a tissue the more I suspect CICO is a harmful oversimplification along the lines of just say no to drugs or abstinence-only sex education.

Our metabolism is amazing and complex but CICO is a matter of thermodynamics.

People get burned when measuring the “out” part because our bodies want to hold on to as much energy as possible.

Not just out, both directions can be tricky to measure. It is hard to say for certain how many potential kcal you're consuming are actually absorbed by the body. If you see whole corn kernels in the toilet, those kcal didn't count :)

But yes. CICO is and always has been absolutely true. People are just overly reductive in how they measure both sides, and then claim that CICO is garbage.

Aren't calorie numbers on foods just made up numbers anyway? I'm no expert but I'm pretty sure that a body's method of metabolizing food is not the same as oxygen burning it. They might offer a standardized number, and a basis for comparison, but other than that it's not reflective of anybody's reality.

In my experience, the most reliable way to understand your body's calorie needs is through consistent measurement:

1. Log everything you eat each day.

2. Weigh yourself first thing the next morning, before eating.

3. Track the trend (did you gain, lose, or maintain?)

Over time, clear patterns emerge. You start to see exactly how your intake maps to weight changes, and you can fine-tune accordingly. It’s not guesswork, it’s feedback.

What surprised me most was how little food I actually needed. Even with regular strength training, a modest surplus was enough to support muscle growth.

From the fine article: >"People often lose muscle and gain body fat as they age—even when their body weight remains the same,"

Often, the whole kernels you see in the toilet aren't actually filled with corn.

You need to get orders of magnitude right at first. I find keeping a punned tab with any AI works pretty well. Drop 5 words with every meal or snack and thats it.

My brother: those kernels are filled with poop.

It’s ok to assume that you absorb 100% of what you eat, unless you see evidence to the contrary, and no corn kernel poop doesn’t count. Frequent diarrhea, weight loss, skin rash, and basically any symptom of vitamin or mineral deficiency.

>It’s ok to assume that you absorb 100% of what you eat

That's not really true. If you've ever done the keto diet, you know that your body expels unburned ketones through your breath, sweat, and urine. Protein can be used to repair structures rather than burned or stored for energy.

There's also something called the "thermic effect of feeding". Your body requires more energy to process protein (20-30% of calories consumed) than it does carbs (5-10%) than it does fats (0-3%).

> you know that your body expels unburned ketones

In other words, "calories out".

Great, but parent is responding to

> It’s ok to assume that you absorb 100% of what you eat

It didn’t get converted to ketones and expelled in your poop.

Your gut absorbed it. That is literally what digestive absorption is about. Expelling ketones is not digestive malabsorption.

Here's evidence to the contrary:

https://www.latimes.com/science/story/2020-02-04/calorie-cou...

It’s not like almonds have x calories for a certain group and y calories for another.

Being wrong about the number of calories in almonds doesn’t count as evidence that skinny people are skinny because they poop out undigested calories.

Also, I’m not saying digestive malabsorption is impossible, just that you shouldn’t assume it unless you have strong evidence to the contrary that doesn’t have another simpler explanation.

CICO is more of an upper bound, but people like to incorrectly use it as a lower bound. Meaning that it's true that you can't burn more calories than you eat, but you can certainly eat many more calories than you store as fat.

(Hell, CICO isn't even valid for something as "simple" as an electric vehicle. My EV's end-to-end efficiency is quite a bit different depending on whether I'm charging from 120V or 240V, the outside temperature at charging time, the outside temperature at driving time, and a handful other factors like state-of-charge. The human body is even more complicated.)

CICO is one of those concepts which is fundamentally correct but can cause so much pain if you follow it religiously and assume all energy sources are the same

I wish I never read IIFYM when I was younger

I think CICO works as long as you view 'diet' as part of your lifestyle rather than an activity.

CICO works perfectly well. It only causes pain because people are addicted to eating and lie to themselves about how much they actually eat.

Study after study has shown that people who claim to not be able to lose weight via diet simply do not have any idea how many calories they are actually eating.

The oversimplification here is that you're assuming that over-consumption is both completely voluntary and the root cause. But it's not - it's actually a symptom.

People overeat for a variety of extremely complex reasons. Mental health, stress, hormonal interactions. gut microbiome, dopamine deficiency, and on.

The assumption that forcing yourself to eat less is solving the root cause is not sound, in my opinion. If you look at GLP-1 inhibitors, those appear to be a much more root cause solution. Rather than solving over-consumption, they solve the propensity to over-consume, which then solves over-consumption.

What we really need to be looking at is why some people have a propensity to over-consume and why some don't. Why are some people destined to a life of constantly fighting food when others don't have to try at all and they stay thin?

Just intuitive, I know this is also the case for other substances like alcohol. I've never had to struggle with alcohol and I never will. I just drink whenever and never think about it. But for some people, it's a lifelong struggle. They have to constantly be thinking about alcohol, and every time it touches there lips it's a problem. Why? Is it genes? Our environment? Psychological support in childhood?

Well sure.

But the fact people over eat so readily is most likely down to the heavily refined food we eat that our hormones aren’t tuned to handle in my opinion.

I know I was miserable on CICO as Iw as constantly going through cycles of gaining then losing lbs. Whereas once I switched to a whole food diet I no longer even need to think about the calories I eat, I just eat when I’m hungry. And I don’t even crave the cookies and marshmallows at all

> because people are addicted to eating

What do you propose to do about that?

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It is an issue. Otherwise you have to file CICO into the category of knowledge that is correct but useless. Like "just read better" for dyslexics.

Right, no one will beat CICO the same way no one will beat death or taxes. It can hurt your feelings, but it's just the truth.

CICO just reflects that dietting is simple, not easy.

CICO is same as when talking about personal finances and distilling it to earn more than you spend. Absolutely truthful statement, but pretty hard very often in practise... And don't really consider many finer points.

Bang on. Indeed, I remember Ramit Sethi (finance blogger) making the same point (https://www.iwillteachyoutoberich.com/the-big-wins-manifesto...)

> As Clotaire Rapaille wrote in his terrific book, The Culture Code,

“Years ago, Tufts University invited me to lecture during a symposium on obesity.

Lecturer after lecturer offered solutions for America’s obesity problem, all of which revolved around education. Americans would be thinner if only they knew about good nutrition and the benefits of exercise, they told us. Slimming down the entire country was possible through an aggressive public awareness campaign.

When it was my turn to speak, I couldn’t help beginning with an observation.

“I think it is fascinating that the other speakers today have suggested that education is the answer to our country’s obesity problem,” I said. I slowly gestured around the room.

“If education is the answer, then why hasn’t it helped more of you?”

There were audible gasps in the auditorium when I said this, quite a few snickers, and five times as many sneers. Unsurprisingly, Tufts never invited me to lecture again.”

You do have me intrigued, what are you general arguments against CICO?

The mechanism from article really does suck, but what does that have to do with CICO? While white adipose cells are created, it's still excess calories that fills those cells.

> You do have me intrigued, what are you general arguments against CICO?

Not the GP, but based on their abstinence-only sex comment I imagine the point being raised is that it's something that is technically true but not a practical guideline.

CICO is a true statement. But you're not going to be able to accurately measure CI and especially not CO. So why bother using that as your guideline on how to proceed? Instead it is known and understood that there are mechanisms for things such as improving CO efficiency, and it's much more practical to focus on that.

Shouldn’t you at least have a ballpark correct CI and CO numbers? If you’re doing +1000 calories per day then whatever CO efficiencies you find won’t do anything

Here's one more. CICO ignores the effects of the types of food (CI) and activities (CO) that might make you hungry quicker than others, for example from sugar or fatigue or anything else. Appetite control is very difficult. Those soft factors make it poor guidance as well.

> CICO ignores the effects

It doesn't though, at the end of the day there's an objective amount of CI and an objective amount of CO. Further, CO isn't just "activities", for instance you burn calories merely by existing. Things you're describing will impact CI and CO, but at the end of the day if one had the ability to fully and 100% accurately measure CI & CO it'd be apparent that the math works.

But this is why "it's just CICO" is at best a tricky phrase. Because the hard part is in the nuance you describe.

I get this over and over on every issue where "math" becomes "guidance". Let me try to bridge by restating:

Math truth is not always good policy guidance.

It is true that CI==CO. It must. It is not true that telling someone that CI==CO is a good way to get them to manage their weight, because (as mentioned) it's hard to measure and (as I added) even if you measure correctly, you _reduce likelihood of compliance_ by ignoring appetite effects when you call all calories equal.

I think we agree, just trying to find the right words anyway.

Exactly, yes we agree. It's why I think the debate is inane from both angles. CICO is both true and yet not useful.

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Right, so, that's what I'm saying. If you don't tell people to do that you're not giving good advice.

You can't outrun your fork (Of course some smart guy will bring up Olympic level athletes, but we're not freaking talking about Olympic level athletes are we?

A 5K run for 30m burns ~300-600 calories. A single serving of a candy bar is ~250 calories. You NEED to restrict the CI portion since its the easiest part of the equation to control.

Indeed. But it cuts both ways.

The typical person who is maligning CICO because it doesn't explain why they're still fat, that person would do much better by better focusing on CICO and performing the all time best exercise for weight loss - the "table push away"

Meanwhile the typical strict advocate of CICO as the end all be all also needs to understand that there's a lot of nuance in both the CI and CO variables.

CICO is necessary but not sufficient. You also need some strategy for how to achieve CO > CI. Different strategies have vastly different implications in regards to willpower, health outcomes, suffering, time, cost, etc.

CICO is the equivalent of engine tuning, to produce more power you just need to burn more fuel in the same amount of time, easy as a concept but not so easy to achieve sometimes.

CICO is an oversimplification that generally assumes that "all calories are equal" on both sides of the equation. On the one side it assumes uniform density of energy in foods and is based on a lot of rough estimates from burning foods in ovens. On the other side, most of our concepts of how much calories we "burn" in a day or given activity and how we use those calories in the complex biology of our bodies is not very far divorced from "assume the body is an ideal spherical furnace" based a lot on CO2 exhaled and temperatures raised. It is a greatly over-simplifying model on both sides of the equation.

Of course, greatly over-simplified models are still useful. CICO as a useful first approximation of a diet still has its uses and its places where it is more useful than some alternative models.

I think food calories and the way we talk about them (like food "contains" them, always burning them) feel a lot to me like the last bastion of Phlogiston Theory in any of the sciences. Chemistry has moved away from the "Calorie" as an approved unit of measure for the more accurate/more reliable "Joule", but also to remove some ties to old Phlogiston baggage.

I think most people would laugh at this idea pushed to its current Physics extreme that food should be measured in Joules by Relativity's infamous E = mc^2 mass-to-energy conversion ratio and that we should assume that the human body is some efficiency percentage of an ideal spherical fusion reactor. Joules In/Joules Out, right?. Why does it sound more accurate to so many as a model when it is "heat particles"/Calories?

(Which again, isn't a call to entirely toss the model, it serves many as a first approximation well enough. But it seems past time to develop better, more targeted models.)

In a perfect world where you measure and control everything 100% CICO rules. However, in the real world, different types of food cause variation both on in and out. E.g. some foods promote feeling to satiety and some foods cause some people to overeat. Diet would also affect gut microbiome which affects hormones/mood etc... If you calculate CICO, then it will still be valid. But from the practical diet approach, CICO is oversimplification.

> But from the practical diet approach, CICO is oversimplification.

No, CICO IS the practical diet. Satiety, microbiome, none of that shit matters. All excuses to not properly stick to the diet. You weigh your food, calculate the macros, and that's it. Zero thought required past that.

It is literally impossible to not lose weight even if you are eating nothing but 500 calories of pure corn syrup every day (Though you may feel pretty sick)

Some people can do macro tracking, others don't have the discipline for it. For those people, shifting to foods with a higher satiety to calorie ratio is a better strategy, or intermittent fasting, or cutting out a food group. As you said, what matters is CICO, not how you achieve it.

I like to compare it to programming. If you tell a C++ developer that their software should have good uptime, your advice here is the equivalent of saying "don't have memory leaks, null pointer dereferces or use-after-free". Yes, all true, but everyone know that. What we need are behaviour patterns like RAII, an extensive test suite, running those tests in valgrind/ASAN, etc. that actually help in a forward looking perspective achieve this goal of not making those mistakes which lead to poor performance.

> For those people, shifting to foods with a higher satiety to calorie ratio is a better strategy, or intermittent fasting, or cutting out a food group.

If they can't have the discipline for CICO, why would you give them benefit of the doubt they have the discipline to "follow" the other methods? It makes no sense.

The discipline needed to resist hunger and the discipline needed to stick to a healthy and varied diet is wildly different. The second may require more thought and skill but a lot less willpower.

It does matter in the real world because practically no one is going to adhere to a diet unless care and consideration has been given to things like satiety.

Adherence is way more important than getting pedantic about thermodynamics.

People fail to adhere to diets because its SO EASY TO MAKE EXCUSES.

People can do intermittent fasting all they want, but if they're eating a stick of butter during feeding times, its worthless. Eating to satiety is useless as a marker because satiety is subjective.

Measuring your food does not give you an excuse to cheat, except the person simply choosing not to do it properly. There are no weird ways of getting around the fact that you have a maximum calorie limit, and thats it.

This is just a reductionist mindset.

Of course satiety and gut microbiome matters.

I'm thin. Do you know what I do to maintain that? Fuck all. I eat what I want, when I want. Do I exercise? No.

Why is it that I don't have to try at all, but you do? Shouldn't you be a little curious, a little jealous? How cool would it be if you could maintain what you have now, but without any of the effort?

There's a lot of stuff I don't care about. I don't care about alcohol consumption either. I drink what I want, when I want. And it works out great for me. For others, that plunges them into a life of alcoholism and they die young of cirrhosis. Why? Why does it work that way? Why is it that I can do whatever but other people can't?

These are the questions we should be asking. You're solving the symptom, not the cause here. Eating too much is a symptom. The root cause is the propensity to overeat. I don't have that propensity, so guess what - I never have to try. But why don't I have it? Will I one day get it?

I'm the same way, and I'm pretty sure there's a big part of the "CO" part that differs among people, namely absorption vs excretion. Suffice it to say I think some bodies "hoard" more than others

Related discussion: https://news.ycombinator.com/item?id=42376760

I'm not curious or jealous at all.

I lost 150 pounds in 2 years and all I did was eat less, and I kept it off easily. I'm not curious because I saw pictures of myself before I lost weight and I saw the plates of food in front of me and it was absolutely disgusting amounts of food.

I feel sick when I eat large amounts of food and I like to keep it that way, and all it needed was getting used to eating less.

Good for you but most people that do just that rebound a few months/years later. Maybe you already had a good enough diet and reducing sizes did it for you but most people require a change in their diet for it to stick. Keeping yourself thin on a highly caloric fast food diet is always harder and if you are already obese you most likely have a problem with food too.

> I did this famously difficult thing therefore it’s easy actually

Some people…

I actually said that CICO works if you control everything and weigh your food and calculate the macros. It may work for you, it works for bodybuilders, but this approach is not necessarily the best. All diets work though reducing calories. Dietary adherence is much more important. Most people are not going to obsessively weigh all their meals. And if you feel sick or hungry all the time, you are much more likely to break the diet.

So, I maintain that, yes, CICO works and calories + macros is the most important. But unless you control intake 100%, then the types of food you consume affect how much you eat, energy levels and compliance. This is especially true long term (over 5 years).

"None of that shit matters" in purely thermodynamic sense, but it matters immensely to the actual goal of getting people to be healthier by having less body fat. In that sense, CICO is an oversimplification.

I personally don't think that anyone without enough will power and discomfort tolerance to feel hungry for long periods of time when surrounded by limitless food should be forced to live a shorter more painful life.

The key to getting people to quit smoking is for them to stop smoking. Very simple. Why on earth do we have nicotine gum and patches?

It's an oversimplification of how the body works to the point of not being useful. For example, if you eat 2500 kcal a day and maintain a steady weight of 150 lbs, it is not the case that if you change your diet to 2200 kcal you will consistently lose X pounds per week. You would more likely lose a bit, then plateau at some level that's hard to predict, because now your body adapted to an input of 2200 kcal a day. Add to this the complication that where those calories come from matters a lot, because when you increase your blood sugar, your body increases insulin which builds up body fat, but if you have eat a low-sugar/carb diet, that happens less. And if you eat sugary foods, you will tend to get hungry more quickly than eating protein-based foods. It's all so person-dependent and food-dependent that just saying "eat less calories and you'll lose weight" does not accurately describe most people's reality.

Your example is the oversimplification that causes people to disbelieve CICO. In your example the body adjusted and the CO wasn't stable. CICO still holds, the flaw is the person assuming their CO was stable.

People who staunchly support CICO as the end all be all talking point miss what you describe. At the same time people who decry CICO as being bogus are missing what I describe. Both are true and both are wrong. It's really just a semantic argument.

If you dropped your calories you wouldn’t expect to loose weight forever, you would expect to loose a bit of weight while your body adapted and then stay at that new weight if you stay at the new lower calories. CICO works well for the vast majority of people, it’s just very hard to know what the balance is and the averaging window is weeks not days.

CICO, like most tautologies, is both definitionally true and fairly useless. Like being asked for financial advice and just saying "MIMO".

People say it because there are all sorts of alternative theories, such as "setpoint theory" that say* that your weight is nothing to do with what you eat.

* Or its proponents say it says

I think this is the most important and practical comment of the thread. Start with this as your "baseline position" and work from there.

"overdrive" isn't a good metaphor most of the time

Let's say they "hit the nitro" (not turbo!) or "floor it" or "give it the beans"

Gaining weight and keeping it is a choice. There are a myriad of solutions some simple like diet and exercise, some more complex like TRT and glp-1 drugs.

I gained a good amount of weight since I had kids, went from a healthy weight of 210lbs at 6'1 to 240lbs at 45 years old.

I always worked out so I had good muscle mass but my diet was terrible, often consuming a pint of ice cream at night once the kids went to sleep.

I got on TRT and compound semaglutide and now I am 215lbs with abs and in the best shape of my life. I recently benched 405lbs at 46 years old. Prior to this I could do 2 pull ups if I was lucky I can rep 10 - 15 now. My stress levels are down, my blood pressure is in a healthy range for the first time in decades. I go to the gym 5 days a week, sometimes 6 and I love it. There are always solutions, we don't have to accept a slow decay.

> Gaining weight and keeping it is a choice

for many people, it is not. you have enough free time, energy, and money to fix your weight issue - many people are missing at least one of these factors, oftentimes more.

there are more complicating factors here too - try telling someone taking lithium that gaining weight is a choice. or birth control, or SSRIs... the list goes on.

yeah, it's pretty easy for you - a middle aged wealthy guy - with enough free time to go to the gym 5-6 days a week - to maintain your weight. most people aren't in that situation.

I've spent years at a healthy BMI when the pandemic was ongoing while getting no exercise. Didn't gain a pound. Weight is all diet. You don't need free time, energy, or money to fix it

i have always maintained a slightly underweight body, well into my 30s, despite limited exercise and unrestricted eating.

i personally know many people who struggle immensely, despite eating far less than me.

for me, it takes exactly 0 effort to remain thin. zero. i literally don't even think about it. other people count every single calorie they eat, exercise religiously, take weight loss medication, and still have trouble managing their weight.

but hunger is a primal thing - some people are far hungrier far more often than other people, for many reasons - and yes, it takes energy to resist hunger.

money and free time aren't required, no, but it definitely helps your odds.

> i have always maintained a slightly underweight body, well into my 30s, despite limited exercise and unrestricted eating

I'm the same, but not because my bodies special. I can very easily gain weight and actually have really bad self control around food.. especially snacks

I pretty recently moved to the US and it infuriates me that so many stores only have 200g+ family-size packs of chips/crisps/whatever you call them.. I want them, but not a huge pack, so I just don't buy them. I know if I keep them at home I'll eat the whole bag in a day

I eat mostly nutritionally dense, unprocessed food because even though I hate cooking I found ways to bulk cook tasty meals and keep them in the fridge/freezer for when I'm lazy and would otherwise order shit

I have breakfast at 1-2pm.. which makes it really hard to overeat in such a short time window before bed. Not for any specific reason I just have coffee before then and it blunts my hunger

I don't think about it either.. but so many of my habits I've built up, if I look at it, make it really hard for me to get fat. I'm guessing you have similar things

"choices" are as much lifestyle design (whether you meant to do it or not) as they are pure willpower. They're all things in your control that can make it so you don't rely on just resisting hunger

You need at least money. In an urban setting a good diet is definitely a sign of at least a mediumly-wealthy household.

Not much. Whole grains, frozen veg, nuts, legumes, fruit, the occasional meat.. all these are cheap. You don't need the highest quality organic foods

There are always excuses. Everything is too hard until you actually do it. Your argument is akin to being told that on average Women are shorter than men and then you say, well I know a tall woman.

There are exceptions but the vast majority of us can accomplish this, we just don't prioritize it. You get what you prioritize.

https://en.m.wikipedia.org/wiki/Survivorship_bias

Your weight is 100% within your control. There is no luck like there is in business, a career, investments or overall health

Survivorship bias is irrelevant

Choice isn't binary, it's a continuous distribution. There are thousands of factors influencing the power you have over your weight. That's why I'm thin and I don't try at all, and other people are overweight and cry from trying so hard.

Are we in agreement that for someone without specific medical issues, gaining weight is caused by eating excess calories?

What other factors influence that outside of you making the choice to eat something?

Can you just make the choice to solve P versus NP? Or climb K2? There's a lot of factors that affect a persons ability to make any choice. Willpower, knowledge and experiences, time, intelligence, etc.

Respectfully, https://en.wikipedia.org/wiki/Rationalization_(psychology)

> we just don't prioritize it

it's a lot easier to prioritize it when you have time, money, and energy. that's my whole point. you are in a position that enables you to manage your weight effectively. many people are not.

>I got on TRT and compound semaglutide

>There are always solutions, we don't have to accept a slow decay.

I find it funny that you say there are always solutions when two of the solutions (or if you bristle at referring to them as solutions in themselves, certainly pieces of a solution) you mention have only really existed for the last twenty years. Semaglutide obviously was only approved by the FDA recently, but the first transdermal/non-injectable Testosterone (which I'm guessing is the form you're taking) replacement therapy was only approved in the late 90's. Most people today, even in developed countries, still can't afford Semaglutide.

I agree with your broader message that people shouldn't give up and should seek to leverage every resource available to them, but there's a faint whiff of moralizing in your comment that seems unearned when it's based upon the happy fortune of living in an era of medical marvels.

Perhaps I should have said: "There are always solutions now" Of course these are new medications but they are widely available. I am not referring to history I am talking about the present. Would think that was relatively obvious, I may have been wrong, which, fair enough.

I'm on injectable testosterone, give myself a shot every week. Semaglutide (compounded not name brand) is relatively affordable. I spend $120 a month on it. If I did the work I could probably get it for cheaper.

Edit: I took a look, appears I can get it for ~$40 a month if I want.

+1 for GLP-1s and TRT.

I went from 220lbs to 160lbs with the help of a GLP-1, but then had to stop due to gallstones and pancreatitis. Now I'm on TRT (under the guidance of a physician) and trying hard to do low carb and high protein. So far so good. And energy level is much higher.

How were you able to find time for gym consistenly with kids + work? Is this because work is relatively stable?

Right now at age 32, I haven't been able to go to gym consistently mainly because work takes so much out of my life/time.

Create a home gym if you're wealthy; buy a set of resistance bands (total cost: $30) and run if you're not (or just frugal and utilitarian). Wake up an hour or two earlier than when your kids do and do your cardio/lifting then.

It takes about two weeks to adjust to the decrease in sleep, but the well-being that exercise provides in my experience more than offsets it.

> Gaining weight and keeping it is a choice.

You are taking an anabolic androgenic steroid. Of course it will help you have muscles and be in "better" shape that when you weren't taking it. Same with the GLP1 drug and weight. You are literally taking drugs to lower your weight and drugs improve your muscle mass. I'm glad you are happy with the way you look now, but setting the bar to "must take drugs to make your body look a specific way that most bodies do not / have not at 45+" is literally part of the problem (or transhumanist). But calling it a choice everyone can make (hundreds of dollars per month plus all the doctors / etc plus all the gym time) is a bit far fetched.

I'm not on GLP1 agonists or TRT. I eat primarily legumes, grain, and dairy. I don't go to the gym. I lift using $30 resistance bands and get my cardio from running and a rowing machine that I used my annual discretionary budget on. And I don't need the rowing machine. He's right.

Humans do homeostasis very well. If you stop exercising at all ("rest days"), your brain normalizes that and creates inertia against resuming exercise. Like all good habits, the point is to make it automatic and the default rather than a choice.

Once you start exercising and make it a non-negotiable daily habit, it becomes progressively harder to stop exercising than to start. Most people that fall out of exercise habits do so primarily because of injuries rather than the failure of the habit itself. You just have to prioritize it ahead of or even alongside other habits (e.g. exercise while watching TV, take the stairs) until it becomes automatic.

Are the people forced into taking statins, high blood pressure medications, etc. due to obesity related issues also “transhumanist”?

We all have to make our own choices but obesity is a choice and the repercussions and treatments are often far worse than the treatments I have selected to avoid it.

Note: You can get glp1 medication for $40 a month if you look for it

Aren't there long-term side effects from TRT? You can never stop as your body ceases to produce T, increased cancer risk, hair loss ?

Respectfully, what are the long term side effects of being obese? Increased risk of cancer, heart disease, etc.

I wasn't making a statement, I was asking if that's indeed true.

Obviously obesity and low T are both pretty bad from a quality of life perspective (if not life expectancy)

Apologies for coming off poorly. Trt doses are generally well tolerated. Blood work is recommended though. Higher doses over time definitely can lead to very bad things including an enlarged heart. I take 1 mg of test cypionate a week. It’s been absolutely life changing. I will never come off of it and never want to.

I inject myself once a week.

It’s positively affected every aspect of my life from work to family to personal satisfaction. At 45 i looked 50. At 46 I look 40.

Energy boost alone makes it sound pretty appealing.

Did you have low testosterone to begin with?

What was it before TRT and what is it after?

Mid 200s before, mid 800s now

Its more complicated than that.

I turned 50 about 6 months ago, I'm 6"2 and dont drink alcohol, dont drink soda, dont eat breakfast and do 45-60 mins of gym weights and cardio 4-5 days a week. I have never been an over eater or a non stop snacker, I do fast food maybe once or twice a week. I drink mostly water.

I just cannot seem to get my gut fat down. I swing from 93-96 kg for no real discernible reasons.

There is something else going on, in my teens till about 35/40 i have always been whip thin.

I dont think we have the answers yet.. so statements like "Gaining weight and keeping it is a choice." is just absurd.

You are 50, you have low testosterone. You should get tested and then get on trt. Don’t let them tell you that you have normal testosterone for a man your age, you don’t want the testosterone levels of a 50 year old, you want the levels of a 20 year old.

Get on testosterone and the weight will fall off.

Your choice. Best of luck.