Paleodyssey

Toward an evolution-informed life

Tag: obesity

In the press recently

Tara Parker Pope has an article in the New York Times Magazine called The Fat Trap about how people who are very overweight are different from the rest of us. They can lose some weight—sometimes a lot of weight—but research suggests that they usually gain it back. Comprehensive, life-changing weight loss is impossible for most people, she concludes.

At the Atlantic, pro blogger Ta-Nehisi Coates references that article and comments that he himself has lost a bunch of weight, but done it slowly over eight years or so.

Obviously I wish this had happened faster and smoother. But the upshot of taking the long way is that I’ve learned a lot about how to negotiate  world where, at almost every step, cheap high calorie food is at the ready. You can’t get that understanding in a lab and you’re unlikely to get if your trying to burn of 3-4 pounds a week. That sounds like masochism.

Megan McArdle, another Atlantic blogger (who had a dustup a few months ago in comments on her blog over the issue of grains with paleo hero Dr. Kurt Harris), responds to Coates’ blog post in What Do We Really Know About Losing Weight? Her main point is that it’s very hard to study weight loss over the long term, because you can’t get a group of participants to stay on one diet, dutifully reporting everything they eat, for many consecutive years.

She has a snarky footnote at the end of her post that references paleo eating.

And yes, this applies to low-carb too; you can keep the weight off if you stay on Atkins/Sugarbusters/Paleo, but just as with other sorts of diets, people mostly don’t.  They do great for 6-18 months, and then they start getting cravings for carbs, and eventually they give in, and the weight comes back . . . and the diet’s advocates explain that of course paleo works, but not for lazy slobs who inexplicably go off it.  At least from what I’ve seen, the pattern is really surprisingly un-different from other sorts of diets.

It’s sort of a fair point. It’s kind of a “duh” that paleo (or any other way of eating that is healthier than an industrial Western diet) doesn’t help you anymore if you stop doing it and go back to eating processed crap. You can lose weight (if you are fat) and get healthier with any reasonable diet if you stick with it.

Paleo is getting more popular now and there are lots of people doing it. If past diet trends are any guide, in 10 years most of the people who have lost a bunch of weight on paleo will no longer be on paleo, and will have gained the weight back. I can argue that paleo is easier than other diets to follow, and in some ways it is. It tends to be satiating and, if done right, is satisfying. There is an online community that provides lots of support, and that’s not likely to change any time soon. However, if you follow paleo blogs you occasionally see one go dark. Sometimes that person comes back a few months later, admitting to having gone off of paleo for one reason or another and proclaiming a renewed commitment to eating well. Those blogs then sometimes go dark again, presumably because it’s frustrating to keep “coming back” to paleo. Most people on paleo have no blog, but there is no reason to think that sticking with paleo over the long term will be what most paleo practitioners will end up doing.

The fact is that paleo is hard. You are surrounded by people who eat differently than you and maybe even make fun of you for it. You have to cook almost all of your food from scratch, which is fun sometimes and a real chore at other times. You have to be careful in restaurants and other places outside your home. It’s kind of tiring. While you’re on paleo you tend to feel great, but once you’ve been off it for awhile there are many factors limiting your motivation to start again.

If you go off of paleo, it’s not because you are a “lazy slob.” Permanent dietary change is challenging in a culture that values convenient, cheap, crappy, heavily advertised food. If you are aware of the barriers and plan around them, you can minimize the chance of falling off paleo so that you can enjoy the myriad health benefits. My biggest hope is that paleo will eventually generate enough interest, money, and research that it becomes mainstream, and something closer to paleo becomes the thing that most recognized health experts recommend. That would generate attempts to monetize paleo, creating fake paleo products, and so on, but it would also make it easier for people to find their way toward real health.

Here’s hoping.

Update: Paul Jaminet uses The Fat Trap article as a springboard to a post on his Theory of Obesity. It is, as usual, thoughtful, well-argued, and interesting. Go read it.

Eating and determinism

On some paleo and low-carb blogs, you find statements such as “you’re not fat and avoid exercise because you eat too much, you eat too much and avoid exercise because you’re fat.” I understand the point. Once you become metabolically damaged, eating an industrial Western diet, and your body is resistant to insulin and leptin, then your body defends the homeostasis of a given level of weight. It will make you incredibly hungry, give you cravings, make you tired, and reduce your basal metabolism as needed to prevent weight loss. There is no reason to blame an overweight person for being overweight, since the same behavior on the part of someone else with different genetics could well produce a skinny person.

Taken too far, however, it suggests that there is nothing that an unhealthy or overweight person can do. If I am overweight and I have no control over that, then it’s not my fault, but I am also just doomed. I won’t be able to change my lifestyle or diet, I won’t be able to get healthy, and I won’t lose weight through any voluntary action. Short of being locked away and placed on a semi-starvation diet, or other coercive intervention by others, there is no way to change. I might be able to choose not to eat a particular doughnut, but I won’t be able to make aggregate decisions about eating and activity that can change my level of overweight or health.

That’s simply not the case, as many people who have made lasting changes in their own eating, exercise, and lifestyle have demonstrated. It is possible to take responsibility for your own health, although that is harder for some people than others. In later posts I’ll discuss some of the factors related to self-management of behavior related to health and wellness.

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