If you're 30 lbs overweight at age 30, then on average over the course of your whole life you've eaten, and stored as fat, about 10 calories a day more than if you hadn't stored those 30 lbs. But I would wager that if you re-ran that person's life, keeping all their macroscopic actions the same except that you reduced their daily caloric intake by one tablespoon of whole milk, that wouldn't result in them being their ideal weight.
Yes, humans tend to overeat when tasty food is available, and eating too much of anything will cause you to gain weight. But when I made my food a lot less processed in early 2020 with a diet overhaul, I went from 45 lbs overweight to 30 lbs overweight even though I was eating more calories (I was using better quality ingredients so everything I cooked tasted better once I learned how to use them. I estimate the increase was around 100-300 extra calories a day). Also I think some body recomposition happened without me doing anything to achieve it because I became noticeably stronger over the next couple of years.
You talk about Americans getting physically larger over time before we started getting fatter, but were old people in 1950 fat because they were now eating as much as their taller grandchildren (I genuinely don't know and would like to)? Why did we start getting shorter again after ~1980? Why, until the 1980s, did we reduce average caloric intake over time as we became more sedentary (even as we grew bigger), and why did that trend break? What are the metabolic effects of other trends over time, like our decreasing average body temperature (it's now 97.9F), or our generational decline in testosterone levels (at least for men, not sure for women)? I can't imagine the effect is zero for all of these, and as noted, we're only trying to explain storing a very small number of excess calories per day (on average).
For me, my WAG is that I think we stopped being able to reduce caloric intake once we became so sedentary that we could no longer do so and still get enough of all the important micronutrients (IDK which ones). Instead, around the same time, we got less micronutrient dense, more processed foods and instinctively ate more to try to compensate. Probably totally wrong in all the details, of course.
Overall, I agree focusing just on the extensive processing is probably the wrong level of explanation, but it's part of a system with lots of large effects pointing in all different directions that somehow collectively added up to us all getting fatter, and saying how big individual effects are is still important data without it actually explaining the overall outcome.
My personal experience is, when I eat processed foods that are low in sugar I don’t gain weight. When I eat large quantities of sugar, I gain weight. When I take a sugar hiatus, I lose weight.
So yeah, based on the data I’ve collected from my own bathroom scale, I don’t blame processed food. I blame sugar.
Sugary foods are typically ultra processed, but there are lots of ultra processed foods with little or no added sugar, and I haven’t found those to be an issue for my waistline.
You have to be wary of category errors. Anytime you lump multiple foods together in one category, if one of them is very bad for you it can make them all look bad even if they are actually harmless. I am personally convinced that while processing may not be good for us, sugar is much worse.
I strongly agree that categories and generalizations are inherently reductive. Some unnatural foods are much better than some natural foods.
I also agree that sugar is the main enemy. Processed foods typically have much more sugar, but not always...
And, sugar is only one piece of the health picture. I was irritated in these comments hearing about studies in which HFCS and sugar produce similar physiological responses. Maybe, but that's so narrow. Natural foods typically contain a much broader spectrum of micronutrients, fibers, antioxidants, beneficial fats, etc. Even when processed foods are enriched, the nutrients are not always bio-available. You may not notice it in your waistline, but maybe it's the difference between your immune system standing tall this year or succumbing to the flu, or feeling lethargic versus having a bit more energy. Over time, maybe it's the difference between developing an auto-immune dysfunction or living healthy into your 70s. When we're talking about digestion and the food that powers human life, there are so many interactions you just can't easily test in a lab. In general, it's readily observable that people with natural diets are typically (not always) healthier.
I have used the analogy of growing food elsewhere in these comments. You can grow food in lifeless dirt packed with NPK from ammonia-based fertilizers. The crops have the macronutrients they need to grow. But, if you grow the same crops in rich living soil, teeming with microbes and worms and organic compounds, the food you grow will be much more nutritive. It will be more resistant to diseases and pests. The human body is the same. It'll grow with just carbs and protein, but all the goodies that are commonly stripped out of foods during processing would do you a lot better.
You should really do some research on the topic it's not hard. You have triggered a pile of nonsense, and a pile of good scientific explanation for obesity. But that was only a product of the superficial nature of your content on this topic. The cardio insulin model is a good place to start. Take a look at shift of nutritional density as we increased yield. The removal of fat in our diet in late 70s. Read Lustigs book. Metabolic health is more serious but similar to obesity. Under our food system 60 years ago, the human body effectively regulated weight despite abundance. My US senate Testimony also touches on the topic. https://youtu.be/3XD96hfirhs?si=M5QNrAjxixndDJ5i
It’s about energy toxicity. It’s not that ultra-processed foods or sugars are inherently bad, but in an overfed state, it can contribute to weight gain, obesity, poor metabolic health. So can a high saturated fat diet if it’s part of an overfed state. The result is visceral fat deposition, when one’s capacity to store subcutaneous fat is exceeded, and insulin resistance will develop and possibly even type 2 diabetes. Sugars/ultra-processed foods in limited quantities can be consumed without adverse consequences, if weight is kept under control. The fructose in ultra-processed foods is identical to fructose in fruits, but fruits have additional health benefits that processed foods lack such as polyphenols and fiber. So fruit is a healthier option.
Regarding diets, there is no one diet that is necessarily superior to another for weight loss. There is long-team data on the benefits of the Mediterranean diet, rich in legumes, olive oil, fish/omega 3’s. Mostly non processed food. But for weight loss, it’s all about caloric restriction , and if that is achieved with intermittent fasting or limiting processed foods or carbs or saturated fats, then whatever works to achieve this is beneficial. The one caveat being a high saturated fat keto diet, which can increase apo-B/LDL-c and contribute to atherosclerosis. So a plant based, high unsaturated fat keto diet would be preferable.
Very good article. I would add that the introduction of artificial sweeteners is a problem. Drinking diet sodas and eating things with artificial sweeteners makes most bodies desire more sweets but have not really been satisfied. In my opinion, we are better off with a little honey or raw sugar where we know how many carbs we are eating.
Matt, this is a topic you ought to consult science based nutritionists. And actually read more books and research in this. Start with Ultra-Processed People. The food industry has been processing food with all sorts of additives to appeal to our taste and desire to eat more
You do know that people who drink diet soda, tend to gain more weight. The substitute, artificial sweeteners trick the body into wanting more. In developing countries we’ve made progress in upping caloric intake, but there’s nutritional deficits.
I love your substack. But here you’ve ventured from your expertise. Of course Americas (and gradually) the rest of the world adopting our junk highly processed foods has not only led to obesity but increase in disease As other countries adopt American processed foods”foods” diseases go up.
People. THE RESEARCH IS REALLY BAD. By necessity, human trials are short, usually include very few subjects AND RELY ON SELF REPORTING. We know more about what goes on in the inside of a star than we do about how the body processes potato chips.
Perfect example: people who drink diet soda might be even heavier if they didn't drink diet soda. Diet soda might be a great way for people prone to obesity to limit their caloric intake. Or maybe it's the opposite. WE HAVE NO IDEA.
Grouchy I am very well aware of the lack of funding for large RCT research regarding nutrition. And the need for more . But why do you you think that is??? Maybe something to do with the power of the corporate food industry.
You cannot ethically run an experiment on a huge number of people, over a long period of time, with total control over what they eat and how much they exercise. This is an inherent and insurmountable obstacle.
Sorry if I came off as too emphatic. This was after reading hundreds of comments.
I think the only thing missing from this is just pointing out the obvious: weight gain is cumulative, so it doesn’t take much imbalance to gain a lot of weight.
People in this thread have gone a bit off the rails. The problem isn’t an epidemic of face-stuffing, it’s mostly just a hundred or so extra calories a day either from being slightly less active or taking in slightly more calories.
The main impact of processed food is that they make the intake part a little easier and it only has to be a little easier.
How about treating obesity with a dose of accountability?
If I have a lot of speeding tickets and accidents, I'll pay more for car insurance. But in most private or public health plans, the overweight chain smoker pays the same as the vegetarian marathon runner.
Overweight chain smokers die early and quickly. It’s the vegetarian marathon runners who languish in memory care for a decade as their body outlives their brains.
Relates to a thought I've had, continuing the auto insurance analogy, that health insurance should be combined with life insurance. After your health care costs reached a certain threshold, you would be "totaled" and get your life insurance payout.
I'm a bit late to the party, but here's something that few commenters have mentioned:
All this focus on *what* we eat, and very little on *how and when* we eat.
When I was a child in Poland, we ate during mealtimes and that was pretty much it. There was more leeway for snacking if you were a child, and it was certainly acceptable to have a pastry and a cup of coffee or tea at a cafe occasionally. But people just didn't stuff their faces with random snacks throughout the day. And this is where processed foods come in: if you're going to shovel food out of a bag into your face while running errands, are you more likely to have chips and candy or some roasted potatoes and broccoli? Exactly.
Basically, it was understood that when you eat, you eat, and when you do other things, you don't eat. I think this goes a long way toward explaining America's obesity rate. It has become socially acceptable to eat at all times during our waking hours.
But obesity rates are rising all over the world. Sure, it's very possible that cultural norms have shifted all over the world. But it's not enough to tell one personal story.
This also might be downstream of the fact that food is cheaper and more delicious. The advancements we've made in food production, storage, and transportation are miraculous. Ending hunger as a major concern is miraculous. But it may simply not have been economical for a corner store to make hundreds of thousands of calories, in every combination imaginable, available for sale.
This is similar to my childhood in the 1960s and 1970s in California. You didn't eat snacks in school. You had breakfast and then you didn't eat again until lunchtime. Sometimes I was starving at 11:00 AM and it was hard to concentrate, but that was just too bad. No eating until noon and the lunch bell rang. Same for the afternoon classes. And you didn't snack before dinner because Mom would yell at you not to ruin your appetite. Sometime after 1980, we entered the world where children couldn't go for 45 minutes without goldfish or Cheerios or whatever, and snacktime is encouraged/enforced in school. I do see both sides, because as I noted, I was often hungry at 11:00 and then again at about 3:30 PM. Maybe Mom would let me have an apple. But substantial snacks weren't encouraged; "snacking" was kind of a bad word.
Random. I lost a huge amount of weight last year. I was too afraid to get on the the scale when I was at my heaviest, but I believe I was 80 pounds overweight. I am now about 15 pounds overweight. I lost the weight with the help of the book The Beck Diet, which is a series of cognitive therapy strategies rather than specific diet or exercise recommendations (it tells you to pick a sensible diet and exercise regimen, but that's it).
And now... we have Ozempic! And I don't qualify, even though I would like to lose more weight, and have to put significant mental energy into watching my calories! 😆
Not to advertise for a particular medication, but I had to quit the booze. Like many people who have to stop drinking, that was replaced with late-night sugar cravings. I would eat healthy all day then murder an entire pint of ice cream or movie-size box of candy.
I exercise a lot, so I'm not hugely overweight and wasn't a perfect GLP-1 candidate. Started taking a drug targeted at binge eating called Contrave, which completely ended all night food cravings without any big side effects.
I feel like I'm cheating a bit. But the doc said now my brain is just working like a lot of people's do by default.
There's a ridiculous amount of science out there that proves certain people are just prone to gain weight and overeat; others won't. The more depressing science shows how much your body wants to regain weight long term after losing it. For the people on here who are all "it's simple, just don't overeat." Let me audit your life a little and find shit that's easy for me that you can't do.
There is some good evidence about this - discussed by Dr. Peter Attia and author Michael Easter in episode #284 of Attia's podcast The Drive (starts about minute 20 or so). They discuss a study by Kevin Hall at NIH that took people and put half on a UHP diet (in a residential facility) for 2 weeks, where they could eat as much as they want, and the other half on a minimally processed diet for 2 weeks, then switched the groups. The UHP diet group ate 500 more calories a day than the minimally processed group. (Easter wrote a fascinating book, Scarcity Brain, that digs into this in much more detail.)
I have my doubts about that study. What is the quality of the institutionally prepared minimally processed food? You need an apples to apples comparison. Tasty well prepared minimally processed food vs UHP.
If the study is Doritos vs hospital food that doesn’t prove the point they are trying to make.
Attia has a fascinating book called Longevity, and he does seem interested in food quality. He discusses several long term studies done on captive apes, whose diets were completely controlled. The studies unintentionally provided the apes with different quality food, with different levels of palatability. Attia believed that there was enough data there to indicate that food quality matters, though he's very honest about how hard it is to draw conclusions given how complex nutritional chemistry is.
according to Easter's discussion, the foods were well matched, so it was a fair comparison. I haven't read the study itself but I think he's a good source
Read Mark Schatzker's "The End of Craving." I know it sounds like crackpottery but it's very persuasive. Farmers/ranchers spend money pumping their feed for pigs and cattle full of vitamins; they do this because it reliably fattens the animals. We also enrich our flour and other ingredients with lots of unnecessary vitamins. The idea that lots of extra vitamins would fatten farm animals and yet does not at all contribute to obesity in people is irrational.
Most of what I've read about ultra-processed foods has been about conditions other than obesity. Cognitive decline, cardiovascular and even a heightened risk of head and neck and esophageal cancer in a large prospective cohort (~450,000 people) with the proportion mediated by obesity deemed small.
Matt, I would love it if you developed a cottage interest in nutritional science. It's fascinating to me how we're simultaneously obsessed with obesity/health and how little good information there is. My impression is that people are reluctant to acknowledge how little we know, and thus spin conclusions despite very little evidence.
An example is how for decades we were told that a glass of red wine a few times a week is good for you, only to conclude that alcohol is never good for you, in any amount. And the mistake was *survivorship bias*. How could researchers and statisticians make the incredibly basic mistake of *survivorship bias*??
Almost nobody is willing to acknowledge that (1) obesity is very unhealthy; and (2) extremely few people successfully lose weight and maintain the loss.
Attia seems to be an exception in this field. Is there a group of experts who are serious about really rigorous nutritional science, meaning they acknowledge how few quality studies there are, and how little we really know?
======
The comments section follows a familiar pattern. People are _convinced_ that their particular food take is correct. Matt says it's not really ultra-processed food, one hundred people respond that it is absolutely ultra-processed food. Pretty much the only thing we know for sure is that smoking is bad for you, and that there are no health benefits to drinking alcohol. _Everything_ else is up for debate.
If you're 30 lbs overweight at age 30, then on average over the course of your whole life you've eaten, and stored as fat, about 10 calories a day more than if you hadn't stored those 30 lbs. But I would wager that if you re-ran that person's life, keeping all their macroscopic actions the same except that you reduced their daily caloric intake by one tablespoon of whole milk, that wouldn't result in them being their ideal weight.
Yes, humans tend to overeat when tasty food is available, and eating too much of anything will cause you to gain weight. But when I made my food a lot less processed in early 2020 with a diet overhaul, I went from 45 lbs overweight to 30 lbs overweight even though I was eating more calories (I was using better quality ingredients so everything I cooked tasted better once I learned how to use them. I estimate the increase was around 100-300 extra calories a day). Also I think some body recomposition happened without me doing anything to achieve it because I became noticeably stronger over the next couple of years.
You talk about Americans getting physically larger over time before we started getting fatter, but were old people in 1950 fat because they were now eating as much as their taller grandchildren (I genuinely don't know and would like to)? Why did we start getting shorter again after ~1980? Why, until the 1980s, did we reduce average caloric intake over time as we became more sedentary (even as we grew bigger), and why did that trend break? What are the metabolic effects of other trends over time, like our decreasing average body temperature (it's now 97.9F), or our generational decline in testosterone levels (at least for men, not sure for women)? I can't imagine the effect is zero for all of these, and as noted, we're only trying to explain storing a very small number of excess calories per day (on average).
For me, my WAG is that I think we stopped being able to reduce caloric intake once we became so sedentary that we could no longer do so and still get enough of all the important micronutrients (IDK which ones). Instead, around the same time, we got less micronutrient dense, more processed foods and instinctively ate more to try to compensate. Probably totally wrong in all the details, of course.
Overall, I agree focusing just on the extensive processing is probably the wrong level of explanation, but it's part of a system with lots of large effects pointing in all different directions that somehow collectively added up to us all getting fatter, and saying how big individual effects are is still important data without it actually explaining the overall outcome.
My personal experience is, when I eat processed foods that are low in sugar I don’t gain weight. When I eat large quantities of sugar, I gain weight. When I take a sugar hiatus, I lose weight.
So yeah, based on the data I’ve collected from my own bathroom scale, I don’t blame processed food. I blame sugar.
Yes, and, processed foods tend to contain much more sugar, especially in the US.
Sugary foods are typically ultra processed, but there are lots of ultra processed foods with little or no added sugar, and I haven’t found those to be an issue for my waistline.
You have to be wary of category errors. Anytime you lump multiple foods together in one category, if one of them is very bad for you it can make them all look bad even if they are actually harmless. I am personally convinced that while processing may not be good for us, sugar is much worse.
Yes and no.
I strongly agree that categories and generalizations are inherently reductive. Some unnatural foods are much better than some natural foods.
I also agree that sugar is the main enemy. Processed foods typically have much more sugar, but not always...
And, sugar is only one piece of the health picture. I was irritated in these comments hearing about studies in which HFCS and sugar produce similar physiological responses. Maybe, but that's so narrow. Natural foods typically contain a much broader spectrum of micronutrients, fibers, antioxidants, beneficial fats, etc. Even when processed foods are enriched, the nutrients are not always bio-available. You may not notice it in your waistline, but maybe it's the difference between your immune system standing tall this year or succumbing to the flu, or feeling lethargic versus having a bit more energy. Over time, maybe it's the difference between developing an auto-immune dysfunction or living healthy into your 70s. When we're talking about digestion and the food that powers human life, there are so many interactions you just can't easily test in a lab. In general, it's readily observable that people with natural diets are typically (not always) healthier.
I have used the analogy of growing food elsewhere in these comments. You can grow food in lifeless dirt packed with NPK from ammonia-based fertilizers. The crops have the macronutrients they need to grow. But, if you grow the same crops in rich living soil, teeming with microbes and worms and organic compounds, the food you grow will be much more nutritive. It will be more resistant to diseases and pests. The human body is the same. It'll grow with just carbs and protein, but all the goodies that are commonly stripped out of foods during processing would do you a lot better.
You should really do some research on the topic it's not hard. You have triggered a pile of nonsense, and a pile of good scientific explanation for obesity. But that was only a product of the superficial nature of your content on this topic. The cardio insulin model is a good place to start. Take a look at shift of nutritional density as we increased yield. The removal of fat in our diet in late 70s. Read Lustigs book. Metabolic health is more serious but similar to obesity. Under our food system 60 years ago, the human body effectively regulated weight despite abundance. My US senate Testimony also touches on the topic. https://youtu.be/3XD96hfirhs?si=M5QNrAjxixndDJ5i
It’s about energy toxicity. It’s not that ultra-processed foods or sugars are inherently bad, but in an overfed state, it can contribute to weight gain, obesity, poor metabolic health. So can a high saturated fat diet if it’s part of an overfed state. The result is visceral fat deposition, when one’s capacity to store subcutaneous fat is exceeded, and insulin resistance will develop and possibly even type 2 diabetes. Sugars/ultra-processed foods in limited quantities can be consumed without adverse consequences, if weight is kept under control. The fructose in ultra-processed foods is identical to fructose in fruits, but fruits have additional health benefits that processed foods lack such as polyphenols and fiber. So fruit is a healthier option.
Regarding diets, there is no one diet that is necessarily superior to another for weight loss. There is long-team data on the benefits of the Mediterranean diet, rich in legumes, olive oil, fish/omega 3’s. Mostly non processed food. But for weight loss, it’s all about caloric restriction , and if that is achieved with intermittent fasting or limiting processed foods or carbs or saturated fats, then whatever works to achieve this is beneficial. The one caveat being a high saturated fat keto diet, which can increase apo-B/LDL-c and contribute to atherosclerosis. So a plant based, high unsaturated fat keto diet would be preferable.
Very good article. I would add that the introduction of artificial sweeteners is a problem. Drinking diet sodas and eating things with artificial sweeteners makes most bodies desire more sweets but have not really been satisfied. In my opinion, we are better off with a little honey or raw sugar where we know how many carbs we are eating.
This has been well studied and thoroughly debunked.
Matt, this is a topic you ought to consult science based nutritionists. And actually read more books and research in this. Start with Ultra-Processed People. The food industry has been processing food with all sorts of additives to appeal to our taste and desire to eat more
You do know that people who drink diet soda, tend to gain more weight. The substitute, artificial sweeteners trick the body into wanting more. In developing countries we’ve made progress in upping caloric intake, but there’s nutritional deficits.
I love your substack. But here you’ve ventured from your expertise. Of course Americas (and gradually) the rest of the world adopting our junk highly processed foods has not only led to obesity but increase in disease As other countries adopt American processed foods”foods” diseases go up.
People. THE RESEARCH IS REALLY BAD. By necessity, human trials are short, usually include very few subjects AND RELY ON SELF REPORTING. We know more about what goes on in the inside of a star than we do about how the body processes potato chips.
Perfect example: people who drink diet soda might be even heavier if they didn't drink diet soda. Diet soda might be a great way for people prone to obesity to limit their caloric intake. Or maybe it's the opposite. WE HAVE NO IDEA.
Grouchy I am very well aware of the lack of funding for large RCT research regarding nutrition. And the need for more . But why do you you think that is??? Maybe something to do with the power of the corporate food industry.
You cannot ethically run an experiment on a huge number of people, over a long period of time, with total control over what they eat and how much they exercise. This is an inherent and insurmountable obstacle.
Sorry if I came off as too emphatic. This was after reading hundreds of comments.
I think the only thing missing from this is just pointing out the obvious: weight gain is cumulative, so it doesn’t take much imbalance to gain a lot of weight.
People in this thread have gone a bit off the rails. The problem isn’t an epidemic of face-stuffing, it’s mostly just a hundred or so extra calories a day either from being slightly less active or taking in slightly more calories.
The main impact of processed food is that they make the intake part a little easier and it only has to be a little easier.
How about treating obesity with a dose of accountability?
If I have a lot of speeding tickets and accidents, I'll pay more for car insurance. But in most private or public health plans, the overweight chain smoker pays the same as the vegetarian marathon runner.
Overweight chain smokers die early and quickly. It’s the vegetarian marathon runners who languish in memory care for a decade as their body outlives their brains.
Relates to a thought I've had, continuing the auto insurance analogy, that health insurance should be combined with life insurance. After your health care costs reached a certain threshold, you would be "totaled" and get your life insurance payout.
I'm a bit late to the party, but here's something that few commenters have mentioned:
All this focus on *what* we eat, and very little on *how and when* we eat.
When I was a child in Poland, we ate during mealtimes and that was pretty much it. There was more leeway for snacking if you were a child, and it was certainly acceptable to have a pastry and a cup of coffee or tea at a cafe occasionally. But people just didn't stuff their faces with random snacks throughout the day. And this is where processed foods come in: if you're going to shovel food out of a bag into your face while running errands, are you more likely to have chips and candy or some roasted potatoes and broccoli? Exactly.
Basically, it was understood that when you eat, you eat, and when you do other things, you don't eat. I think this goes a long way toward explaining America's obesity rate. It has become socially acceptable to eat at all times during our waking hours.
But obesity rates are rising all over the world. Sure, it's very possible that cultural norms have shifted all over the world. But it's not enough to tell one personal story.
This also might be downstream of the fact that food is cheaper and more delicious. The advancements we've made in food production, storage, and transportation are miraculous. Ending hunger as a major concern is miraculous. But it may simply not have been economical for a corner store to make hundreds of thousands of calories, in every combination imaginable, available for sale.
This is similar to my childhood in the 1960s and 1970s in California. You didn't eat snacks in school. You had breakfast and then you didn't eat again until lunchtime. Sometimes I was starving at 11:00 AM and it was hard to concentrate, but that was just too bad. No eating until noon and the lunch bell rang. Same for the afternoon classes. And you didn't snack before dinner because Mom would yell at you not to ruin your appetite. Sometime after 1980, we entered the world where children couldn't go for 45 minutes without goldfish or Cheerios or whatever, and snacktime is encouraged/enforced in school. I do see both sides, because as I noted, I was often hungry at 11:00 and then again at about 3:30 PM. Maybe Mom would let me have an apple. But substantial snacks weren't encouraged; "snacking" was kind of a bad word.
Random. I lost a huge amount of weight last year. I was too afraid to get on the the scale when I was at my heaviest, but I believe I was 80 pounds overweight. I am now about 15 pounds overweight. I lost the weight with the help of the book The Beck Diet, which is a series of cognitive therapy strategies rather than specific diet or exercise recommendations (it tells you to pick a sensible diet and exercise regimen, but that's it).
And now... we have Ozempic! And I don't qualify, even though I would like to lose more weight, and have to put significant mental energy into watching my calories! 😆
Not to advertise for a particular medication, but I had to quit the booze. Like many people who have to stop drinking, that was replaced with late-night sugar cravings. I would eat healthy all day then murder an entire pint of ice cream or movie-size box of candy.
I exercise a lot, so I'm not hugely overweight and wasn't a perfect GLP-1 candidate. Started taking a drug targeted at binge eating called Contrave, which completely ended all night food cravings without any big side effects.
I feel like I'm cheating a bit. But the doc said now my brain is just working like a lot of people's do by default.
There's a ridiculous amount of science out there that proves certain people are just prone to gain weight and overeat; others won't. The more depressing science shows how much your body wants to regain weight long term after losing it. For the people on here who are all "it's simple, just don't overeat." Let me audit your life a little and find shit that's easy for me that you can't do.
There is some good evidence about this - discussed by Dr. Peter Attia and author Michael Easter in episode #284 of Attia's podcast The Drive (starts about minute 20 or so). They discuss a study by Kevin Hall at NIH that took people and put half on a UHP diet (in a residential facility) for 2 weeks, where they could eat as much as they want, and the other half on a minimally processed diet for 2 weeks, then switched the groups. The UHP diet group ate 500 more calories a day than the minimally processed group. (Easter wrote a fascinating book, Scarcity Brain, that digs into this in much more detail.)
This was a study on twenty people over the course of four weeks. Suggestive, but Attia would be the first to admit that it's not conclusive.
I have my doubts about that study. What is the quality of the institutionally prepared minimally processed food? You need an apples to apples comparison. Tasty well prepared minimally processed food vs UHP.
If the study is Doritos vs hospital food that doesn’t prove the point they are trying to make.
Attia has a fascinating book called Longevity, and he does seem interested in food quality. He discusses several long term studies done on captive apes, whose diets were completely controlled. The studies unintentionally provided the apes with different quality food, with different levels of palatability. Attia believed that there was enough data there to indicate that food quality matters, though he's very honest about how hard it is to draw conclusions given how complex nutritional chemistry is.
according to Easter's discussion, the foods were well matched, so it was a fair comparison. I haven't read the study itself but I think he's a good source
Read Mark Schatzker's "The End of Craving." I know it sounds like crackpottery but it's very persuasive. Farmers/ranchers spend money pumping their feed for pigs and cattle full of vitamins; they do this because it reliably fattens the animals. We also enrich our flour and other ingredients with lots of unnecessary vitamins. The idea that lots of extra vitamins would fatten farm animals and yet does not at all contribute to obesity in people is irrational.
Most of what I've read about ultra-processed foods has been about conditions other than obesity. Cognitive decline, cardiovascular and even a heightened risk of head and neck and esophageal cancer in a large prospective cohort (~450,000 people) with the proportion mediated by obesity deemed small.
https://link.springer.com/article/10.1007/s00394-023-03270-1
Matt, I would love it if you developed a cottage interest in nutritional science. It's fascinating to me how we're simultaneously obsessed with obesity/health and how little good information there is. My impression is that people are reluctant to acknowledge how little we know, and thus spin conclusions despite very little evidence.
An example is how for decades we were told that a glass of red wine a few times a week is good for you, only to conclude that alcohol is never good for you, in any amount. And the mistake was *survivorship bias*. How could researchers and statisticians make the incredibly basic mistake of *survivorship bias*??
Almost nobody is willing to acknowledge that (1) obesity is very unhealthy; and (2) extremely few people successfully lose weight and maintain the loss.
Attia seems to be an exception in this field. Is there a group of experts who are serious about really rigorous nutritional science, meaning they acknowledge how few quality studies there are, and how little we really know?
======
The comments section follows a familiar pattern. People are _convinced_ that their particular food take is correct. Matt says it's not really ultra-processed food, one hundred people respond that it is absolutely ultra-processed food. Pretty much the only thing we know for sure is that smoking is bad for you, and that there are no health benefits to drinking alcohol. _Everything_ else is up for debate.
An appropriate Simpsons clip for my reaction upon opening this morning's comments section:
https://youtu.be/UkJehlr1tEw?si=bDmsKps9WcTlgkYz