willsun
Joined 14 years ago
Karma
77
Submissions
21
Member since
Nov 13
Recent submissions
Comment · 4 years ago
Comment · 7 years ago
This is an insightful point, and has been demonstrated in several studies [1] - limiting variety simplifies and bounds the food decisions you have to regularly make.
[1] https://onlinelibrary.wiley.com/doi/full/10.1038/oby.2005.10...
Comment · 7 years ago
Certainly abuse and addiction management has improved since the 1960s - but companies have struggled to get more stimulants to market because of other side effects as well (e.g. fenfluramine was quite effective, but withdrawn in the 1990s since it was found to cause heart valve disease / pulmonary hypertension). At this point, broader adoption of medications seems to be blocked by a combination of physicians choosing not to prescribe, payers unwilling to pay (e.g. $300/mo indefinitely), and patients who don't like the non-trivial side effects of existing options. Perhaps future drug discovery will alleviate these issues.
Comment · 7 years ago
I think this is a fair point, and the final section of the post attempts to address this. For what it's worth, most studies do not selectively draw from a highly-motivated cohort - participants are rarely the most severely obese, and they also usually aren't people who are actively looking for clinical trials or free weight loss programs. Money is also controlled for, since the interventions are almost always offered for free, and any time or work involved with the study will be compensated as well. From my perspective, if anything, the motivational factor may actually be _too_ well-controlled in many of these studies, so the observed result does not translate properly to real-world settings.
Comment · 7 years ago
Yup - there are several studies [1][2] that have looked into this, and regular weighing (e.g. daily) looks like it has a small but significant effect that helps with weight loss.
Comment · 7 years ago
Most of the studies I looked at would "enforce" diets through direction, coaching, and meal plans, while a few provided meals to participants. Very few required daily calorie tracking. So while it is possible there is an adherence improvement for certain diets (e.g. low-carb has better satiety, better adherence, and therefore better weight loss), that improvement doesn't appear to be significant enough to regularly appear in research studies. Of course, one could make the methodological critique (e.g. "the studies aren't good enough yet to detect this"), but at least it seems to set a ceiling on the magnitude of a possible adherence improvement.
Comment · 7 years ago
This is a good point - I'll caveat this in the post. Most medication/placebo studies tend to involve a bit of coaching in addition to the medication, usually 1 session per month or less with instruction on diet and exercise. So the 25% result is essentially "coaching-lite + sugar pill", which may be considerably more expensive than a simple placebo. This result could be much weaker if it's just the placebo alone.
Comment · 7 years ago
The Science rebuttal raises an interesting philosophical question - if evidence about industry influence is not slam-dunk, as it asserts SRF's influence here was not[1] - then to what extent is it appropriate that meta-conversations about nutrition science invoke external "machinations" to strengthen scientific shifts? For example, if, say >95% of the shift from "bad fat" to "bad sugar" was driven by improved scientific methodology (which the Science article seems to suggest), it seems like a risk of disproportionately highlighting the remaining negligible influence may artificially support the new status quo.
[1] "As we have also shown, the sugar industry approached Hegsted only after learning of the results of his dairy industry–backed study suggesting that fat and not sugar was a factor in heart disease. “There was no, ‘We’ll get money from them and make the results come out this way,’” recalled Lown, who worked in the department. “It didn’t happen that way,” he said."
Comment · 7 years ago
Do you mind sharing which interventions you're familiar with that result in average weight loss of 15% or more?
Comment · 7 years ago
Out of curiosity - when you stopped taking the meds, do you feel like there was some residual craving-preventive effect that remained? I'm surprised medications like this aren't prescribed more frequently, and my assumption is that payers / doctors aren't keen on having their patients use it indefinitely (which I'm not sure is necessarily a bad thing, if there are no side effects)
Comment · 8 years ago
Thanks for clarifying - this is an important point and seems to explain why there was no noticeable weight loss.
From the paper: "During the test phase, participants’ energy intake was adjusted periodically to maintain weight loss within 2 kg of the level achieved before randomization."
Comment · 8 years ago
Yup - this line of reasoning is also expressed by Dr. Hall, in the slide here [1]. To answer your question, the study specifically states: "On average, body weight changed by less than 1 kg during the test phase, with no significant difference by diet group in either the intention-to-treat (P=0.43) or per protocol (P=0.19) analysis."
It is interesting that the study authors highlight the higher energy expenditure as an advantage for weight loss, but do not seem to directly address that they did not observe this advantage during the 20 week study period.
[1] https://twitter.com/YoniFreedhoff/status/1062762047677571079
Intent helps people eat better and simplify their lives. Figuring out what to eat is a common struggle of modern life - we solve this. Our app makes personalized meal plans tailored to your goals, preferences, constraints, and routine. We're rapidly growing, people love our app, and we're funded by top investors.
We're looking to hire software engineers to help us craft intuitive user experiences for our native iOS app, and to design and scale our backend services. Creating personalized meal plans is a non-convex optimization problem, so the architecture and technical constraints we use are especially important. Our stack includes Swift, Node, Python, Postgres, and Redis. You'll play an integral role in building and scaling the product, and your compensation will reflect this.
Feel free to reach out directly, will [at] intentapp.com