Of course, it "doesn't work" because people don't keep it up. I started exercising regularly during covid and didn't stop. I cut out all the soda. It works.
We’re on fluoride from the water our entries lives, iodine in the salt and various B vitamins, iron and calcium in the flour. Why stop there? This has been an overwhelming coup for public health.
I dropped from the mid 300s 10-15 years ago to 260-ish these days. It fluctuates from 250 to 280 over time, but keeping off weight long-term by changing diet is very much doable.
That should be very doable for most people. 250 is overweight for everyone under 7 feet tall, and 280 is obese for everyone under 6 foot 9 inches (that's about 99.997% of the population, if my data source is correct). For the vast, vast majority of people 350 pounds would be somewhere in the mid-40s BMI.
If you want to not be fat, exercise and eat fewer calories. Full stop.
The fact that a certain group of individuals don’t have that self control is just evidence that education and public health have a place. Drugs won’t solve that.
These drugs are needed for people with metabolic disorders caused by years of food abuse or poor genetics. It’s not a population wide solution.
We have 50+ years of incontrovertible evidence that that advice doesn’t work for the overwhelming majority of people.
“Just have self control” is the stupid take imho.
A meta-analysis of 29 long term weight loss studies[1] found:
> By 5 years, more than 80% of lost weight was regained
I think a much better hypothesis is that CICO does work, physically, but there are metabolic, hormonal and mental factors that either predispose towards obesity or make it difficult to escape.
It's a bit like telling gambling addicts to "just stop gambling" or depressed people to "lighten up".
And along comes GLP-1 drugs, where obese people find it easy to lose weight, find new motivation for life, etc. The GLP-1s aren't increasing metabolism, nor are they making people exercise, nor are they making food less available. Yet somehow, a hormonal mediation is greatly successful, hmm.
