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9 hours ago, Aqua Buddha said:

I'm not being a dickhead.  I'm just treating you like an alcoholic would and you think that makes me a dickhead.  You're just simply wrong about long term weight loss and it doesn't matter how you feel.  Your opinion is like me telling an alcoholic at rock bottom what to do about it.  I can give my opinion but I'm still wrong.  And no, I wasn't in your situation because I stopped it before it got that bad.  I was gaining 10 lbs per year.  Had it gone another few years, I'd have been 300 lbs.  

But you clearly have an issue with food.  You need to admit that as the first step.  If you don't, that surgery will be a waste and you'll be back where you started.  I love those people in that alcoholic thread and they'd treat you worse than me.  I love them because they recognized where they were and the lack of power they had over it and took control.  They also didn't blame anyone else and they hold people accountable.  You may respond better to positive affirmation but you also need some tough love and someone to hold you accountable.  

I hope your surgery works out well in the long run but know that you have ownership in that outcome just like you have ownership as to why it got that way in the first place. 

Interesting. And yet you come off like a complete piece of shit in this thread.  

Maybe your first step should be to acknowledge that you’re an asshole, then you can work on it.  You know - follow your own advice. 

 

 

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4 minutes ago, Gatorubet said:

Interesting. And yet you come off like a complete piece of shit in this thread.  

Maybe your first step should be to acknowledge that you’re an asshole, then you can work on it.  You know - follow your own advice. 

 

 

Yes, I am an asshole.  I have been for years.

But I'm not wrong.

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17 minutes ago, Gatorubet said:

Interesting. And yet you come off like a complete piece of shit in this thread.  

Maybe your first step should be to acknowledge that you’re an asshole, then you can work on it.  You know - follow your own advice. 

 

 

Wulaw needs some tough love.  He also needs to approach this subject with at least an ounce of humility.  He's completely powerless.  Instead, he's lectured everyone about how impossible it is to lose weight but he's somehow found the solution and no other solution works despite a mountain of evidence.  The truth is, he's on his last solution and if this doesn't work, his next 10 years will end badly.  He needs to accept where he is.  He's at rock bottom.  He needs to have an honest assessment of the place food takes in his life.  He also needs to quit smoking.  His diet leading up to his surgery was, quite frankly, pornographic.  People on this site supported him but they shouldn't have.  They weren't doing him any favors.  

But yes, I am an asshole.  But like I said, I'm not wrong.

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26 minutes ago, Celery Man said:

Stupid basic advice but getting some AirPods, the Libby app (or audible) and listening to books (or just… music) while doing boring exercise things made it a much better experience for me.

Still find it tedious. Riding a bike is more enjoyable. Swimming is more enjoyable. Running wind sprints until I puke is more enjoyable. 

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1 hour ago, Sawbonz said:

I was going to stay off this thread, but in general I respect your posting over the years and I think you mean well on this thread despite your tone in these more recent posts. You clearly don’t know shit about fuck wrt human physiology in general, much less the specific pathophyisology and neuroendocrine pathways in play when going from ideal body weight to overweight, to obese, and then to morbidly obese, and your personal experience and anecdotal knowledge of “literally dozens” of people who are outliers is no basis for drawing any conclusions about Wulaw’s situation. 
 

I linked a really good article about some of  the pathways involved. Either you didn’t bother reading it or you didn’t understand it. I don’t have the patience to give you a primer, but you are wrong about most of what Wulaw’s problems are, and the way  you present the parts you are right about is not helpful, and in fact is counterproductive. IDGAF if you are an asshole. Most of us here are. I do wonder what you are hoping to accomplish with these posts. 
 

While there is plenty of psychological overlay in becoming obese, there are mechanisms at play at the cellular and even molecular level that contribute to causing maintaining and exacerbating obesity, and they have nothing to do with willpower or food addiction or stress eating. Exercise most definitely does have positive effects  

 

I suggest you go read about adipocytes, metabolic syndrome, glucagon-insulin homeostasis, leptin and leptin resistance, leptin agonists, leptin mechanism of action in the hypothalamus/brainstem vs gut mechanoreceptors and their respective effects on satiety, and white adipose tissue and its effects on leptin production. If you had to google any of these terms you should STFU on this thread other than to offer encouragement 

Yes, all of that is and it makes it harder for some people to lose weight than others but it doesn't make it impossible.  Sure, there are the 2% cases but that's not what we're talking about.  I spent this morning in a run group on a hurt foot and in that group are at least 25 people who have impressive weight loss stories and kept the weight off and yes, it's fucking hard.  To say it's impossible is insulting to the people who have done it.

Like I said, these are all conditions and it's the patients job to manage conditions.  Being an alcoholic is no different.  They have a medical condition that makes them predisposed to being an alcoholic.  No one would suggest an alcoholic keep moderately drinking.  They need to change their lifestyle.  Same with the obese.

My encouragement is to say quit making excuses and just do it and I'd say that to anybody.  The whole excuse making and saying it's impossible encourages people to not even try.

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2 hours ago, Sawbonz said:

I was going to stay off this thread, but in general I respect your posting over the years and I think you mean well on this thread despite your tone in these more recent posts. You clearly don’t know shit about fuck wrt human physiology in general, much less the specific pathophyisology and neuroendocrine pathways in play when going from ideal body weight to overweight, to obese, and then to morbidly obese, and your personal experience and anecdotal knowledge of “literally dozens” of people who are outliers is no basis for drawing any conclusions about Wulaw’s situation. 
 

I linked a really good article about some of  the pathways involved. Either you didn’t bother reading it or you didn’t understand it. I don’t have the patience to give you a primer, but you are wrong about most of what Wulaw’s problems are, and the way  you present the parts you are right about is not helpful, and in fact is counterproductive. IDGAF if you are an asshole. Most of us here are. I do wonder what you are hoping to accomplish with these posts. 
 

While there is plenty of psychological overlay in becoming obese, there are mechanisms at play at the cellular and even molecular level that contribute to causing maintaining and exacerbating obesity, and they have nothing to do with willpower or food addiction or stress eating. Exercise most definitely does have positive effects  

 

I suggest you go read about adipocytes, metabolic syndrome, glucagon-insulin homeostasis, leptin and leptin resistance, leptin agonists, leptin mechanism of action in the hypothalamus/brainstem vs gut mechanoreceptors and their respective effects on satiety, and white adipose tissue and its effects on leptin production. If you had to google any of these terms you should STFU on this thread other than to offer encouragement 

One more thing to add and it's too late to edit my other post.

While these conditions are legit, they do not excuse the no exercising.  You will not lose weight and maintain weight without it.  I'm only talking 30-60 minutes per day for a prolonged period of time.

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3 minutes ago, Aqua Buddha said:

Yes, all of that is and it makes it harder for some people to lose weight than others but it doesn't make it impossible.  Sure, there are the 2% cases but that's not what we're talking about.  I spent this morning in a run group on a hurt foot and in that group are at least 25 people who have impressive weight loss stories and kept the weight off and yes, it's fucking hard.  To say it's impossible is insulting to the people who have done it.

Like I said, these are all conditions and it's the patients job to manage conditions.  Being an alcoholic is no different.  They have a medical condition that makes them predisposed to being an alcoholic.  No one would suggest an alcoholic keep moderately drinking.  They need to change their lifestyle.  Same with the obese.

My encouragement is to say quit making excuses and just do it and I'd say that to anybody.  The whole excuse making and saying it's impossible encourages people to not even try.

You clearly read nothing I posted.  I am not talking about the 2%. It is incredibly difficult to get to healthy weight from morbid obesity and stay there. I am talking about the vast majority of morbidly obese people. Like Wulaw. You know,  the people for whom physicians and surgeons - people who actually have done more than consult google and their personal experience to learn about this stuff - are recommending medication and even surgical treatments.

 

Molecular biology and pharmacokinetics are not excuses. You should stop posting in this thread 

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8 minutes ago, Sawbonz said:

You clearly read nothing I posted.  I am not talking about the 2%. It is incredibly difficult to get to healthy weight from morbid obesity and stay there. I am talking about the vast majority of morbidly obese people. Like Wulaw. You know,  the people for whom physicians and surgeons - people who actually have done more than consult google and their personal experience to learn about this stuff - are recommending medication and even surgical treatments.

 

Molecular biology and pharmacokinetics are not excuses. You should stop posting in this thread 

I've read everything you've posted and you're right on all counts.  I define obese as over 300 pounds.  (Height and gender may vary.)  While you're saying it's incredibly difficult, I know dozens of people who have done it so it's possible so to write it all off to biology discounts their work and achievement?

Serious question.  I don't know your area of practice but would you ever prescribe an exercise regimen to a patient?  I know a neurologist and he does that.  He also bitches out patients for being fat.  

Exercise is the key to the whole equation but what's the fun in that?

 

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Just now, Aqua Buddha said:

I've read everything you've posted and you're right on all counts.  I define obese as over 300 pounds.  (Height and gender may vary.)  While you're saying it's incredibly difficult, I know dozens of people who have done it so it's possible so to write it all off to biology discounts their work and achievement?

Serious question.  I don't know your area of practice but would you ever prescribe an exercise regimen to a patient?  I know a neurologist and he does that.  He also bitches out patients for being fat.

 

I think a lot of the problem with the American healthcare system is the incentive for doctors to just prescribe meds for ailments related to having obese patients.  Oh, high BP due to being fat?  Here's a pill.  High cholesterol from eating fast food every day?  Here's a pill.  Type 2 diabetes for being over overweight and eating like shit the majority of your life?  Here's a pill and blood sugar monitor.  Granted, some people may actually have high BP or cholesterol and be a perfectly healthy weight and they actually need these drugs but the vast majority of the people who are type 2 diabetic, have high BP or high cholesterol have these issues due to weight and diet.  However, there's no proactive measures for doctors or the pharmaceutical industry to get these people off these medications because the incentive structure is backwards.  The structure incentives doctors to keep these patients coming back to them for more drugs and the pharmaceutical companies keep pumping them out.  If the government actually incentivized people to be healthy, it could dynamically shift the health trends we've seen over the last 20/30 years.  However, too many lobbying programs are on capital hill trying to get their shitty processed foods into our laps (dairy industry, big beef, etc.).

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1 minute ago, Aqua Buddha said:

I've read everything you've posted and you're right on all counts.  I define obese as over 300 pounds.  (Height and gender may vary.)  While you're saying it's incredibly difficult, I know dozens of people who have done it so it's possible so to write it all off to biology discounts their work and achievement?

Serious question.  I don't know your area of practice but would you ever prescribe an exercise regimen to a patient?  I know a neurologist and he does that.  He also bitches out patients for being fat.

 

I’m an orthopedist. I prescribe exercises to every single patient. I recommend specific diet adjustments if they are overweight. If they are morbidly obese and have tried and failed to lose weight and they need surgery I refer them for evaluation for bariatric surgery. If Mounjara gets an FDA approval for weight loss I will prescribe it. You don’t know what you are talking about 
 

Exercise is not a panacea. You can balance your quad and hamstring strength perfectly and if you have an ACL Deficient knee and a pivot shift, your only option is surgery. If you have a large disc herniation and a foot drop, strengthening your core is not going to help you. If you are a 60 yo woman and had a total hysterectomy and removal of both ovaries in your 30s and never got HRT doing squats and bench presses at the gym and taking calcium and vitamin D  is not going to cure your osteoporosis. You need medication. If you are type 1 diabetic you cannot control your blood sugar with diet and exercise.

You know dozens of people who successfully lost weight and maintain weight loss. Yet studies and surveys and population data make it clear those people are outliers. 
 

 

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6 minutes ago, pearlandhorn said:

I think a lot of the problem with the American healthcare system is the incentive for doctors to just prescribe meds for ailments related to having obese patients.  Oh, high BP due to being fat?  Here's a pill.  High cholesterol from eating fast food every day?  Here's a pill.  Type 2 diabetes for being over overweight and eating like shit the majority of your life?  Here's a pill and blood sugar monitor.  Granted, some people may actually have high BP or cholesterol and be a perfectly healthy weight and they actually need these drugs but the vast majority of the people who are type 2 diabetic, have high BP or high cholesterol have these issues due to weight and diet.  However, there's no proactive measures for doctors or the pharmaceutical industry to get these people off these medications because the incentive structure is backwards.  The structure incentives doctors to keep these patients coming back to them for more drugs and the pharmaceutical companies keep pumping them out.  If the government actually incentivized people to be healthy, it could dynamically shift the health trends we've seen over the last 20/30 years.  However, too many lobbying programs are on capital hill trying to get their shitty processed foods into our laps (dairy industry, big beef, etc.).

Did you read anything I posted? JFC

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5 minutes ago, Sawbonz said:

You know dozens of people who successfully lost weight and maintain weight loss. Yet studies and surveys and population data make it clear those people are outliers. 
 

 

I get that these people are outliers (myself included) and can appreciate a doctor (like yourself) who recommends diet and exercise.  However, patients aren't incentivized to actually follow through with said diet and exercise, are they?  No, their insurance will cover the cost of these drugs that enable their current lifestyle.

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12 hours ago, pearlandhorn said:

Costco, smuckers, Trader Joe’s…there’s literally countless non sugar added PB in a grocery store.

There are also a lot of different reading lessons on the market and you seem to have avoided them all.

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2 hours ago, Sawbonz said:

I’m an orthopedist. I prescribe exercises to every single patient. I recommend specific diet adjustments if they are overweight. If they are morbidly obese and have tried and failed to lose weight and they need surgery I refer them for evaluation for bariatric surgery. If Mounjara gets an FDA approval for weight loss I will prescribe it. You don’t know what you are talking about 
 

Exercise is not a panacea. You can balance your quad and hamstring strength perfectly and if you have an ACL Deficient knee and a pivot shift, your only option is surgery. If you have a large disc herniation and a foot drop, strengthening your core is not going to help you. If you are a 60 yo woman and had a total hysterectomy and removal of both ovaries in your 30s and never got HRT doing squats and bench presses at the gym and taking calcium and vitamin D  is not going to cure your osteoporosis. You need medication. If you are type 1 diabetic you cannot control your blood sugar with diet and exercise.

You know dozens of people who successfully lost weight and maintain weight loss. Yet studies and surveys and population data make it clear those people are outliers. 
 

 

Serious question.  If it's genetics, then why are certain parts of the country more obese than others and why has obesity increased over time, especially in the last 3 years?

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2 hours ago, pearlandhorn said:

I get that these people are outliers (myself included) and can appreciate a doctor (like yourself) who recommends diet and exercise.  However, patients aren't incentivized to actually follow through with said diet and exercise, are they?  No, their insurance will cover the cost of these drugs that enable their current lifestyle.

The follow through is the key.  Results are far from immediate.  In fact, I've seen people gain weight initially because they're adding muscle mass or eating more because their body needs it.  This can be a long hard process and most people don't have the patience.  Sure, my wife went from  fat to a 3:45 marathon but that took literally six years.

The real issue that these pills and surgeries can't fix is someone's relationship with food and that should be examined on a deeper level.  (Drugs and alcohol are the same.)  You can have a surgery or get a pill but if you don't examine that underlying cause, you'll be back where you started unless you plan on taking Ozympic the rest of your life.  (They spend $100M/yr on advertising, so maybe that's part of the plan.)

The Suplee article does a very good job on both of these and shows that yes, it can be done.

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46 minutes ago, Aqua Buddha said:

Serious question.  If it's genetics, then why are certain parts of the country more obese than others and why has obesity increased over time, especially in the last 3 years?

There are so many fucked up genetic phenomenons almost completely unique to the American south uneducated suburbs/exurbs/rural areas.  

To 59burst's point...yeah...changing the physical rhythms is one thing and you start to feel/see changes in just days to weeks.  The mental hardwiring takes a fuckton longer and is a very white-knuckling experience.  Took me awhile to realize the term "muscle memory" is way more memory, than muscle..

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4 hours ago, Aqua Buddha said:

Serious question.  If it's genetics, then why are certain parts of the country more obese than others and why has obesity increased over time, especially in the last 3 years?

Why are you focusing on genetics out of everything I have written? 

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4 minutes ago, Sawbonz said:

Why are you focusing on genetics out of everything I have written? 

Then educate me.  Why are people in certain regions in America more prone to obesity than others?  If it's beyond their control, why are they different?  Also, why have obesity rates spiked in recent years?  What has changed in the brain or gut in that short amount of time and why didn't it effect people around the country equally?

Serious question.

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Just now, Aqua Buddha said:

Then educate me.  Why are people in certain regions in America more prone to obesity than others?  If it's beyond their control, why are they different?

Serious question.

I don’t have the time or patience to educate you. I have never said it’s all genetics. You seem to have latched on to genetics and or are conflating genetics with physiology and pathophysiology. I have tried to explain some of  the biochemical pathways involved, and I have never said they are impossible to overcome for everyone. If that is what you are inferring from what I have written then either I am terrible at explaining or you are dug in on your position. In any case further discussion is unlikely to be productive 

 

 

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55 minutes ago, Sawbonz said:

I don’t have the time or patience to educate you. I have never said it’s all genetics. You seem to have latched on to genetics and or are conflating genetics with physiology and pathophysiology. I have tried to explain some of  the biochemical pathways involved, and I have never said they are impossible to overcome for everyone. If that is what you are inferring from what I have written then either I am terrible at explaining or you are dug in on your position. In any case further discussion is unlikely to be productive 

 

 

So, it's the biochemical pathways?  My mistake.  Sorry about that.  (Really.)  How and why have those changed for certain parts of America and not others and why did they change so much over the past few years?  Explain it to me like I'm five.  Something has changed in America (see below) and it's been region specific (see below).

And no, you never said they were impossible to overcome.  Wulaw did.  That's when I stepped it.  He clearly doesn't understand diet, health, and fitness and I don't mean that as an insult, believe it or not.  He was here lecturing everyone and had zero humility.  Recovering alcoholics would never tolerate that mindset from someone who needs recovery.  He was wanting to be on par with alcoholics and I treated him like that.  

Someone should ask whim "why do you eat so much?"  Someone once asked me that about booze and I embarrassingly didn't have an answer.  Whatever that reason is is a far bigger driver than his biochemical pathways.    These people can't have it both ways.  They can't want to be medically on par with alcoholics but get mad when we treat them like that when they won't even take the first step.

usa-obesity.png?w=1200

 

Chart_Obesity2022-1024x553.png

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7 minutes ago, Neonmoon said:

I would LOVE to see an overlay of education rankings by state on that map 

You don't have to see it.  You know the answer already in both education, income, and rural vs urban.  Poor and rural people eat like ass and don't exercise for a whole list of reasons.

A good example right now is Cracker Barrel.  They're having all sorts of problems.  They're business model is delivering a pornographic amount of food to pseudo rural types along the interstates for $12.  Their customer base has a very low price ceiling but they still expect the volume of food.  (Why?)  With inflation being what it is, CB, can't deliver on the bottom line.  Their trade off is either raise prices or smaller portion sizes.  Instead, they're selling booze.  (Lulz.)  Guess where CB is big around the country?

Now, Sawbonz (who seems very well educated on this, BTW) might come along and tell me these people's systems have been rewired because of their diet.  That may be true but the root cause is still the diet.

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I'm not sure how well it is understood, but carbs, sugar, and alcohol are all pretty closely related chemically and in their effects on the brain and endocrine system.  Sawbonz or some other medico can perhaps elaborate.  They all do a number on blood sugar and that in turn does a number on your brain.  Even sugar substitutes, without the calories, seem to have a lot of the same effects.

All humans that imbibe much alcohol, or another addictive drug, will experience tolerance (moar!) and physical withdrawal (puke +).  Those are the symptoms or characteristics of "physical addiction."  I suspect that similar things happen with food, and particularly starchy, carby, sugary foods, which is a whole hell of a lot these days.  That can make stopping or reducing intake of those substances quite unpleasant, even if one is not a full-blown addict.

I think it's also clear that a lot of overeaters eat "emotionally," to alter or regulate their psychological well-being, which is one of the more psychological aspects of drug/alcohol addiction.

One of the more defining characteristics of the addict/alcoholic is a craving for the substance of choice long after physical withdrawal has passed.  I think we all get food cravings from time to time, as well.

Throw all that shit together and it's a pretty toxic recipe for obesity and one that can be hard to overcome.

I stayed pretty slim when drinking excessively because alcohol does a pretty good job substituting for food in a variety of different ways.  I didn't balloon up after stopping, either.  But I do recognize that I can have a pretty unhealthy relationship with food if I don't watch it.  For me, as long as I don't overindulge quantity or crappiness too much, it kind of takes care of itself.  But the notion of rewarding myself with something big or shitty or both occurs to me all too often, as well as "fantasizing" about some particular food.  Most of the time, I am able to use my internal dialog to just say "stahp."

 

 

 

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2 minutes ago, YGIFS said:

That map…Apparently in the words of Dr Dean Wormer…fat, white, and southern is no way to go through life fellas.  

The real separator is income/zip code.  Poor whites, black, and hispanics all have similar metrics because they all eat like ass and don't move.  Same with upscale whites, blacks, and hispanics.  They eat better and exercise more.

Now, you'll get a bit of sympathy from me about how difficult it is to be working poor while also eating better and exercising.  I also know they just like shit food.

And the end of the day, it's not demographics or molecular makeup.

The root cause is diet and exercise.  

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43 minutes ago, Aqua Buddha said:

So, it's the biochemical pathways?  My mistake.  Sorry about that.  (Really.)  How and why have those changed for certain parts of America and not others and why did they change so much over the past few years?  Explain it to me like I'm five.  Something has changed in America (see below) and it's been region specific (see below).

And no, you never said they were impossible to overcome.  Wulaw did.  That's when I stepped it.  He clearly doesn't understand diet, health, and fitness and I don't mean that as an insult, believe it or not.  He was here lecturing everyone and had zero humility.  Recovering alcoholics would never tolerate that mindset from someone who needs recovery.  He was wanting to be on par with alcoholics and I treated him like that.  

Someone should ask whim "why do you eat so much?"  Someone once asked me that about booze and I embarrassingly didn't have an answer.  Whatever that reason is is a far bigger driver than his biochemical pathways.    These people can't have it both ways.  They can't want to be medically on par with alcoholics but get mad when we treat them like that when they won't even take the first step.

usa-obesity.png?w=1200

 

Chart_Obesity2022-1024x553.png

 

What does any of this have to do with morbidly obese people’s ability to lose weight and maintain weight loss? 

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3 minutes ago, Sawbonz said:

How does knowing the root cause of obesity help an already morbidly obese person lose weight and maintain weight loss? 

As a physician, shouldn't you want to know the root cause of a condition in order to prevent it?  Also, if addressing the root cause can also cure the symptoms and prevent surgery, isn't that a good thing for the patient?

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1 minute ago, Aqua Buddha said:

As a physician, shouldn't you want to know the root cause of a condition in order to prevent it?  Also, if addressing the root cause can also cure the symptoms and prevent surgery, isn't that a good thing for the patient?

This is the fat people thread. The person you have aimed most of your posts at is already morbidly obese (and currently well on his way to just obese and hopefully then to his ideal body weight). If you want to start a thread on how to prevent obesity knock yourself out. It will probably get plenty of traction. Telling an already fat person over and over and over how they could have avoided getting fat in the first place is not fucking helpful. If you can’t see why then you have some issues to work on

 

 

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1 hour ago, Aqua Buddha said:

So, it's the biochemical pathways?  My mistake.  Sorry about that.  (Really.)  How and why have those changed for certain parts of America and not others and why did they change so much over the past few years?  Explain it to me like I'm five.  Something has changed in America (see below) and it's been region specific (see below).

And no, you never said they were impossible to overcome.  Wulaw did.  That's when I stepped it.  He clearly doesn't understand diet, health, and fitness and I don't mean that as an insult, believe it or not.  He was here lecturing everyone and had zero humility.  Recovering alcoholics would never tolerate that mindset from someone who needs recovery.  He was wanting to be on par with alcoholics and I treated him like that.  

Someone should ask whim "why do you eat so much?"  Someone once asked me that about booze and I embarrassingly didn't have an answer.  Whatever that reason is is a far bigger driver than his biochemical pathways.    These people can't have it both ways.  They can't want to be medically on par with alcoholics but get mad when we treat them like that when they won't even take the first step.

usa-obesity.png?w=1200

 

Chart_Obesity2022-1024x553.png

If West Virginia would only try a little harder, they could be the sole leader in the clubhouse at over 40% obesity.

I also assume that North Dakota hears smack from South Dakota about being Fattys. But maybe North Dakota has a bunch of Louisiana residents working on a pipeline up there, so who knows?

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11 minutes ago, Sawbonz said:

This is the fat people thread. The person you have aimed most of your posts at is already morbidly obese (and currently well on his way to just obese and hopefully then to his ideal body weight). If you want to start a thread on how to prevent obesity knock yourself out. It will probably get plenty of traction. Telling an already fat person over and over and over how they could have avoided getting fat in the first place is not fucking helpful. If you can’t see why then you have some issues to work on

 

 

Yes, it's the fat person thread.  That includes how to not be fat.  I respect your opinion on this but I've also asked you to break it down by socio economic and regional differences and you haven't and we both know why and that's fine.  This isn't the cancer thread.  That is a disease that picks people at random.  This is the fat thread and that does not pick people at random.

What you are missing is the emotional part.  You are a subject matter expert on the physical body.  I am an expert on the emotional.  I get people to want what they do not need.  On another thread, you would learn that I am a purveyor of high end whores.  You could ask the same question I ask of that fats.  "Why do you do it?"  Well, that's complicated in both cases and in each case, the emotional far outweighs the physical.

In short, it's what do you eat and why do you eat it?

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Just now, Aqua Buddha said:

Why do you do it?"  Well, that's complicated in both cases and in each case, the emotional far outweighs the physical.

In short, it's what do you eat and why do you eat it

What you do not understand, and I’m done arguing about it, is that the how and why someone becomes fat is not the same as the how and why they stay fat, or get fatter, or regain the weight they have lost, if and when they do. WRT the latter it has much more to do with neuroendocrine and biochemical pathways than it has with anything “emotional”. The science on this is fairly clear. I have continued posting not to try to convince you because I honestly don’t give a fuck but for others who may be reading this and struggling with the same issues that Wulaw is. 
 

and just to be clear I haven’t broken down weight loss efforts by socio economic strata or geographic regions because other than access to healthcare resources they are largely irrelevant. 

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45 minutes ago, Sawbonz said:

What you do not understand, and I’m done arguing about it, is that the how and why someone becomes fat is not the same as the how and why they stay fat, or get fatter, or regain the weight they have lost, if and when they do. WRT the latter it has much more to do with neuroendocrine and biochemical pathways than it has with anything “emotional”. The science on this is fairly clear. I have continued posting not to try to convince you because I honestly don’t give a fuck but for others who may be reading this and struggling with the same issues that Wulaw is. 
 

and just to be clear I haven’t broken down weight loss efforts by socio economic strata or geographic regions because other than access to healthcare resources they are largely irrelevant. 

OK, I've respected your knowledge but at this point you need to respect mine.  To say weight loss efforts  by socio economic class are irrelevant except for access to health care is, quite frankly, ignorant.  I don't mean that as an insult.  I just know what people eat and why they eat it.  I more than respect your life's work so respect mine and, by the way, you're wrong.  You can ask me any question like I've asked you and I'll answer them with no judgement.  However, you are completely in the dark if you think think that emotions have nothing do with food.  

I've learned things by your postings because you're an expert in your field.  I'm an expert in cheap food for Americans.  You should learn something from me if you're going to diagnose fatness in American patients.  

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1 hour ago, Sawbonz said:

What you do not understand, and I’m done arguing about it, is that the how and why someone becomes fat is not the same as the how and why they stay fat, or get fatter, or regain the weight they have lost, if and when they do. WRT the latter it has much more to do with neuroendocrine and biochemical pathways than it has with anything “emotional”. The science on this is fairly clear. I have continued posting not to try to convince you because I honestly don’t give a fuck but for others who may be reading this and struggling with the same issues that Wulaw is. 
 

and just to be clear I haven’t broken down weight loss efforts by socio economic strata or geographic regions because other than access to healthcare resources they are largely irrelevant. 

BTW, since we're talking about Wulaw, he's clearly an "emotional" case.  He's talked in the other thread about it.  He's been fairly transparent, actually.  Most obese people are emotional cases.  You don't physically need 5K calories to get through the day.

I've really liked your scientific perspective on this.  I've actually learned a lot.  But you need to understand when it comes to things like obesity and alcoholism that the emotions are far more important than you think they are.  

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What you do not understand, and I’m done arguing about it, is that the how and why someone becomes fat is not the same as the how and why they stay fat, or get fatter, or regain the weight they have lost, if and when they do. WRT the latter it has much more to do with neuroendocrine and biochemical pathways than it has with anything “emotional”. The science on this is fairly clear. I have continued posting not to try to convince you because I honestly don’t give a fuck but for others who may be reading this and struggling with the same issues that Wulaw is. 
 
and just to be clear I haven’t broken down weight loss efforts by socio economic strata or geographic regions because other than access to healthcare resources they are largely irrelevant. 

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