Korea has a similar lack of obesity. It's not just genetics because Koreans tend to become overweight when living in the US.
I think it comes down to two major factors:
1. Koreans tend to walk (exercise) more. Walk (partway) during commute, walk to lunch, walk to do errands, etc. In the US people just sit in their cars. I personally find I get 3000+ daily steps in Korea without even trying, while in the US I only get about 300 daily steps or so.
2. Diet + portions. My Korean friend was astounded by the amount of fries that came with every meal in the USA and Canada. The US is the only place where fructose is substituted for sugar in most processed food. I've heard fructose inhibits the sense of satiation after eating.
So walkable cities and better food options would probably reduce US obesity.
Americans do more exercise than ever and have also reduced their sugar intake on average, but obesity continues to rise. Is it possible that food additives or something less obvious is having an effect? GLP-1 agonists are a good indicator that even minor chemical interventions can have a huge long-term effect on obesity that dominates diet and exercise, so why do we rule out the possibility of other substances doing the opposite?
Are they really? Fitness socials exploded in the last 10 years, many more enthusiasts training harder/longer, but I haven't seen noticably more bodies at the gym.
My understanding is that GLP-1 affects appetite, and thus affects diet. And one of the reasons people quit GLP-1 long-term is because they miss eating and enjoying food.[1]
> The drugs work by activating GLP-1 receptors in the body in a way that reduces appetite, alters gut function, and may impact addiction pathways.[2] However, adherence to the drugs long-term is a challenge, as many people stop taking them after some time.
when you are walking everywhere for a few minutes at a time, it adds up rather quickly.
most americans who go to the gym spend 60 ish minutes there. they also usually eat something after.
i don't think it's food additives, because japanese are no stranger to mass produced food and beverages from food conglomerates. it's the country that gave us instant noodles.
> Koreans tend to walk (exercise) more. Walk (partway) during commute, walk to lunch, walk to do errands, etc. In the US people just sit in their cars.
People are always going on about walking, but I have a very hard time believing that the lack of low-intensity walking is a major contributing factor for the 250-pound bodies that are so common in the US (especially south and midwest). When you're overwhelming your body with fried food every day and coke at every meal, you ain't gonna keep up with those calories by getting in more steps.
People think of the 250lb and 1000 steps in the context of one meal, or maybe a 6 month diet. But 250lb is not added in one meal, or over 6 months. It usually takes a couple of decades.
Let's say that's 10,0000 days. Because I'm Australian and like round numbers and am lazy (these numbers are all very rounded), call 250lb 100kg. 1,0000 steps a day consumes about 20 kiljoule. If those kilojoules come from eating fat, you either add 1/2 a gram of fat or walk those 1,000 steps.
I know, 1/2 a gram, 0.02oz - almost insignificant, right? Now multiply it by 10,000 and see that over those decades it contributed 50kg of the 100kg we are talking about.
For the same reason exercise doesn't make a lot off difference to a 6 month or even 2 year diet. But when you are trying to explain to difference between trim Koreans and 250lb Americans those extra 3,000 steps a day explain the entire difference, then some.
I don’t know the science of it but for me at least walking suppresses my appetite. My hunch is that by not walking the body goes into “must be sick, should probably eat some more” mode.
Basically it's all about Calories and Americans have added 25% to their caloric intake since 1961 when it started increasing.
Its also not really magical, they didn't just add sugar, they added meat, sugar, grains and oil (replacing butter mostly) - all together it adds up to 720 kcal extra per day per capita.
Koreans eat about 1500 kcal less per day (they are also quite a bit smaller on average so it's not 1 ot 1 of course.) Japanese eat even less (like 200 kcal less) but are also even a bit smaller on average. Both countries happily eat terrible food just as much as Americans do these days, they just eat a lot less food in total.
There's an idea that American eat out more and that the calories at dining establishments about increased about 35%.
Only 25% of Americans are getting the recommended aerobic activity. Which is 20 minutes per day of moderate activity (walking).
It is difficult to comprehend how little most Americans walk. In many suburbs, the local store is more than a mile, which would equate to a 40 minute round trip walk. How often do you walk for 40 minutes when you can drive in 8 minutes. Of course, delivery services only exacerbate the issue, as you're not even walking through the parking lot now.
Japanese people fry all kinds of food. They have plenty of soda as well, and there are plenty of Americans who struggle with obesity despite not drinking much soda.
It 100% has to do with walking/biking and portion sizes. Low intensity exercise throughout the day is as if not more effective than high intensity exercise for burning calories and keeping your metabolism from crashing.
I know a person with sort of an odd type of diabetes that requires multiple different ways of treating to keep her blood sugar low. She was taught to walk daily, not to help her blood sugar today, but to literally help it tomorrow. Her data seems to back this up.
Whatever the cause, there seems to be a causal relationship with brisk walking and lower blood sugar the following day.
Food in the US seems designed to make people obese.
When you look at ingredient labels in Japan or Germany, you see a short list of what you would expect, plus maybe a preservative.
In the US, you see an entire chemistry lab: artificial colors and flavors, bizarre substitutes for real sugar, oils that a hundred years ago would not be considered fit for human consumption, and so on.
Granted, this is hardly accurate/scientific - try out a solid hour walk on a treadmill.
A lot of steps for a pittance of calories [based on whatever hand-wavy math it's doing, admittedly]. We're frustratingly efficient. I forget exactly, it was something dumb like half a candy bar.
I've heard people say "you won't outrun your mouth", in this context... and others.
It's true. I've managed to drop my body weight ~half, it happened by controlling what I ate; not how I exercised. When I stopped skateboarding due to an injury, I ballooned. I stopped eating like that over a decade later, I shrunk.
In that time I also got older, moved, and went to college. It's worth considering what's easier/more likely/realistic to maintain
The walking may not be what actually loses the calories but it probably also affects how you look at your own fitness. It gets a lot harder to walk when you're heavy, and you'll notice quickly when you get start getting winded just going to work every day.
I recently wore a FreeStyle Libre for 10 days and one of the most positive things I learned from it was 10-15 minute walk after a meal significantly dropped glucose levels. It would reduce the spike in the range of 5-10% immediately. After I noticed that effect, a quick Google search presented many articles confirming it.
I strive for 7k steps per day since Covid hit March 2020. Some days I may fall a little short if really tired or sore from golf or coaching little league the previous day, but most days I easily achieve it or go well over. I surely don't think 7k is an unreasonable goal for ANYONE - it just takes a little bit of mentality change and effort that just seem taken for granted in the USA from what I have observed last few years.
Things like parking near the rear of parking lots when going to stores. I am amazed now at how often I see people wasting many minutes in their cars just to wait or "hunt" for closer spots when they could have just parked in back and be walking into the store already. Or parents at the park sitting and reading their phones for an hour while their kids play in playground. Teenagers riding electric scooters/ebikes instead of walking or regular bikes, etc.
I was at my in-laws over Christmas and everyone sitting around eating one of the many appetizers to choose from and drinking alcohol, I decided I wanted to go for a quick mid-afternoon walk just for some fresh air. I remember sort of being giggled at when I asked if anyone wanted to go, with a few bewildered looks on some faces. Again it is a change of mentality that needs to happen if obesity is going to be addressed in the US anytime soon. Now, with these drugs available, I'm afraid it will be even harder to get to the root of the problem.
I don't know the proper sources, but I've read in several places that the Netherlands continues to have rising obesity despite making exactly those sorts of reforms over the past ~40 years.
Well, the local diet isn't particularly great, with a strong preference for preprocessed food (kant en klaar). And it could could be argued that the quality of the fresh produce coming from their greenhouses is also suboptimal, from a nutritional point of view..
Average Japanese walk 2000-2500 steps more per day than Americans. India has walkable cities, but still they don’t walk, and they have lower longevity despite an even lower average bmi.
Yes, I lived in Japan for a few years and those are the exact same two conclusions I came to, with the only additional one being much less added sugar/high fructose corn syrup. Food is generally much less sweet there.
> I've heard fructose inhibits the sense of satiation after eating.
You’re pretty much on track until this. The idea that a specific subtype of sugar has slightly different effects on the body might technically be true, but it’s a small drop in the bucket when compared to the huge increase in calorie intake in general. When this idea started circulating, it seemed like a food company misinformation campaign.
Mhhh apple contains fructose and my doctor suggested it to calm down big hunger without overeating (which it does), but i don't know if there are differences when it's pure vs inside an apple
Realistically, if you eat smaller servings and walk more, it's easier to have a healthy weight.
The last time I went to Japan with an American friend, she commented that the portion sizes in Japan were so small. Combined with all the walking from using trains (we'd easily get more than 10k steps per day), we both lost weight during that trip.
When I lived in Japan everyone who would come visit me would look at restaurant menus and ask “why are the small and large beers the same price? Who would ever buy the small?”
Locals would say matter of factly “you only order the large when you want more.”
Also many restaurants offer Tabehoudai and Nomihoudai, “all you can eat and drink” respectively.
All the servers would come to see when the Americans would order nomihoudai and request a pitcher of beer.
“Okay, one pitcher for the table.”
We’d always get a laugh when we’d say, “Actually, one pitcher for each of us.”
Walking less is not the cause of the obesity, more like the other way around: if you don't need to walk, you can afford to overeat until you're obese. Also the pleasure of walking and exercising must be replaced with something else.
But exercise has very little effect on weight compared to diet. It's a known fact, even for the fans of counting calories. Just see the tables of inputs and outputs.
Eating less and avoiding sugar and processed food is mostly enough, if not to be slim, at least to keep you reasonable healthy.
> But exercise has very little effect on weight compared to diet. It's a known fact, even for the fans of counting calories. Just see the tables of inputs and outputs.
Also, some studies suggest that up to some threshold, exercise reallocates those calories from autonomic functions rather than actually adding to total expenditure [1]. It's been further speculated based on this that some of the health benefit of exercise might simply be a result of taking energy away from anxiety/stress responses.
> But exercise has very little effect on weight compared to diet. It's a known fact, even for the fans of counting calories.
I recognize that this is conventional wisdom, but it hasn't been borne out by my own results losing well over 100 pounds / roughly 40% of my body weight over the course of several years.
I've counted calories strictly, with the same methodology and same limit, and documented weight regularly, both during low-activity low-altitude winters and medium-activity, high-altitude summers. The results I got, over the major windows in which I got them, were as follows:
I'm defining "high" activity here as "regularly exercising to physical exhaustion", "medium" as "regularly climbing up hills that cause me to breathe heavily but don't exhaust me", and "low" as "regular walking but nothing that strains my body meaningfully".
This is now data collected over years of weight loss and multiple seasonal changes in location and activity, and I find it difficult to explain this within the context of standard weight loss advice. Exercise at altitude seems to burn far more calories than it "should", by a factor of four or five times.
I walked a mile or two every other day on average across this period, meaning the only difference is a roughly 15 to 30-minute walk up a steep slope roughly every other day. A typical calculator will tell you this "should" burn on the order of 100-150 calories, but the data suggests it's closer to 500-1000.
I'm not a doctor, so I don't know why this is. I've largely ruled out:
- Diet, which is conserved across locations fairly well (I cook most of my own food using widely-available ingredients)
- Seasonal effects, unless they happen to produce very sharp discontinuities at the exact time I relocate each year
- Emotional state, since these results have been robust to both positive and negative emotional states in both locations
- Temperature, which is near-constant year round (because I live in warm places in winter and cold places in summer)
- Groundwater, because I drink almost entirely bottled water and not local water supplies
- Major underlying medical causes (my bloodwork is great and I don't have any reason to think I'm sick)
I have a working hypothesis that the studies that established calorie burn from exercise (which I believe largely did it by measuring CO2 exhalation) were missing a great deal of the actual energy cost, because the costs of anaerobic respiration take place over hours following exercise and not just during it. But I also can't imagine people with actual medical expertise haven't thought of this before. A negative correlation between altitude and obesity rates is well-established, so something is going on.
In any case, the data is the data, and it points very strongly towards altitude and exercise, synergistically, being almost exclusively the source of my own weight loss.
I wish this was understood more. To burn 1K kcalories takes considerable effort. To not ingest them, avoid that pizza. Hell, pizza +beer or coke probably is way more.
> Realistically, if you eat smaller servings and walk more, it's easier to have a healthy weight.
Yeah, many years ago as a student I spent a summer in Manhattan. The diet probably couldn't have been more different than Japan, but the combination of walking a ton compared to the suburbs where I grew up, and the fact that as a poor student in a very expensive city my portions were smaller out of necessity (e.g. my snacks were usually fresh fruit sold outside of a store/bodega) I got much healthier.
This is a stark contrast to North America where there are generally no trains to walk to catch, but rather simply a few steps from your door to your car.
My point being that the design of our society right down to the topography of our physical spaces is not set up to encourage walking.
We can’t even agree that obesity is a problem, instead choosing to talk about beauty in all shapes and sizes and other woke nonsense (to be clear: I consider myself a liberal) that masks true objective facts about health.
If we could agree on a goal, perhaps we could then have real conversations about how to get there. But instead we are so fractured and our governments so inept and conflicted that we subsidize the food that makes us sickest.
> My point being that the design of our society right down to the topography of our physical spaces is not set up to encourage walking.
There are places where it's downright hostile, with areas with no sidewalks or crossings.
> But instead we are so fractured and our governments so inept and conflicted that we subsidize the food that makes us sickest.
There's actually a somewhat sane rationale for the agricultural subsidies. For the longest time in human history, famine was always looming, and the best policy to avoid it was to store excess calories in case of a bad harvest year.
Whether or not that still applies in the US can be debated though.
GLP-1 Agonists are very interesting drugs. There are ongoing clinical trials for their application in neurodegenerative diseases because they seem to have, among others, excellent neuroprotective effects, they are great at lowering inflammation. There is a good paper about that. I think it's misleading and ridiculous to say that Japan does not need Ozempic. Not all obesity is simply caused by eating habits. There is a very important factor that has to do with oxidative/nitrosative stress and inflammation that may as well have to do with other underlying diseases, syndromes, etc. and that we are just starting to understand. The science is not "settled" with obesity, as much as we've progressed with understanding it, and it's really weird to me for someone to use such a clickbait title...
[0] https://doi.org/10.1177/20420188231222367
Have you or someone you know ever willingly made a lasting and meaningful lifestyle change? Chances are it was very difficult. Food choices and behaviors are especially hard as they are sometimes cultural and deeply rooted in people's psyche.
Intelligent people have died from diabetes and other obesity related illnesses, not because they couldn't understand calorie math or what carbohydrates are, but because they couldn't or wouldn't change their eating habits in the long term.
If by lifestyle you mean behavioral disorder, It seems to me that the science from the last 10 years is starting to point in the opposite direction. If I may recommend, there is a great presentation by Dr. Robert Lustig called "Fat Chance: Fructose 2.0".
[0]: https://www.youtube.com/watch?v=ceFyF9px20Y
I am very annoyed that even a food scientist put very different food cultures into 'western' food then he meant American diet . European food cultures are way too diverse to even combine it.
And Italian diet has a similar simplistic philosophy. French food does not. Both can keep you slim.
It’s dangerous and misleading when reporters conflate controlled scientific studies with anecdotes that haven’t proven true when properly studied:
“I had learned there are massive health benefits to reversing obesity with these drugs: for example, Novo Nordisk ran a trial that found weekly injections reduced the risk of heart attack or stroke by 20% for participants with a BMI over 27 and a history of cardiac events. But I also saw there are significant risks. I interviewed prestigious French scientists who worry the drugs could cause an increase in thyroid cancer, and eating disorders experts who worry it will cause a rise in this problem. Other experts fear it may cause depression or suicidal thoughts. These claims are all fiercely disputed and debated. I felt trapped between two risky choices—ongoing obesity, or drugs with lots of unknowns.”
So, I know this isn't the point you were making--and I also certainly am not saying this correlation could mean what it would look to imply--but a little part of me read your comment and went "huh: so if the Japanese people 'don't need Ozempic', are they also already experiencing the side effects?"... and, I correctly hazily remembered, they are: "In 2017, the country had the seventh highest suicide rate in the OECD, at 14.9 per 100,000 persons, and in 2019 the country had the second highest suicide rate among the G7 developed nations." (per Wikipedia).
There are many reasons including prevalence of fast food locations, ultraprocessed foods, food marketing, car culture, social tolerance, and sedentary lifestyles. So much would have to change in America, including attitudes, to make a dent.
PS: Ozempic is not for weight management, it's for blood sugar control. Wegovy is a higher dose for weight management and not covered by Medicare discriminating against all causes of obesity without nuance.
Japan has 1000x more accessible food within walking distance than America does, plus vending machines EVERYWHERE. I think it’s mostly smaller portions and not eating sugar in huge quantities.
>There are many reasons including prevalence of fast food locations, ultraprocessed foods, food marketing, car culture, social tolerance, and sedentary lifestyles
Of course they’re more healthy, they eat less & walk more.
I just returned from Japan, and the difference in quality of life due to urban density, reliable public transit, and walkability of every city I visited is staggering. There really is no comparison to the United States. Everything you could ever need to live is within walking distance - seriously. This is the way people are meant to live.
Except for the minor issue that this density plays a significant part in Japan's well-below-replacement-popluation birthrate.
You may have noticed, walking around Tokyo, the lack of children. I certainly do every time I'm there -- I live about two hours away in a bedroom community, where you absolutely do need a car to get around.
Most Tokyo families have one and only one child.
Out where I live, where 1000sqft+ houses are the norm, three or more is not uncommon.
That's a fair point. I hadn't considered it from the perspective of having space for children, though I don't personally think the density of Tokyo is prohibitive.
I'm curious about another thing: You mention 1000sqft+ homes being the norm where you're located, is that considered a larger than average home in Japan? I can't find a recent figure for average dimensions of a Japanese home. The average in the United States, by comparison, is apparently 2273sqft (reported in 2021).
ie. Japanese take their trash home from stadium and theaters.
Meanwhile in America we throw the trash out of the window of their car into the parking lot while parked 10 feet away from a dumpster.
I am sure somewhere in Japan there are obese people and those who throw their trash into the parking lot but they are the exception not the norm where it is reverse in America.
But if it takes a drug to help drive down obesity I have no problem with people taking it, but we've got to address the cost which is ridiculous and unacceptable.
Readit News
I think it comes down to two major factors:
1. Koreans tend to walk (exercise) more. Walk (partway) during commute, walk to lunch, walk to do errands, etc. In the US people just sit in their cars. I personally find I get 3000+ daily steps in Korea without even trying, while in the US I only get about 300 daily steps or so.
2. Diet + portions. My Korean friend was astounded by the amount of fries that came with every meal in the USA and Canada. The US is the only place where fructose is substituted for sugar in most processed food. I've heard fructose inhibits the sense of satiation after eating.
So walkable cities and better food options would probably reduce US obesity.
Are they really? Fitness socials exploded in the last 10 years, many more enthusiasts training harder/longer, but I haven't seen noticably more bodies at the gym.
> The drugs work by activating GLP-1 receptors in the body in a way that reduces appetite, alters gut function, and may impact addiction pathways.[2] However, adherence to the drugs long-term is a challenge, as many people stop taking them after some time.
[1]: https://youtu.be/d3X3HPp44b8?t=951
[2]: https://youtu.be/d3X3HPp44b8?t=239
most americans who go to the gym spend 60 ish minutes there. they also usually eat something after.
i don't think it's food additives, because japanese are no stranger to mass produced food and beverages from food conglomerates. it's the country that gave us instant noodles.
People are always going on about walking, but I have a very hard time believing that the lack of low-intensity walking is a major contributing factor for the 250-pound bodies that are so common in the US (especially south and midwest). When you're overwhelming your body with fried food every day and coke at every meal, you ain't gonna keep up with those calories by getting in more steps.
Let's say that's 10,0000 days. Because I'm Australian and like round numbers and am lazy (these numbers are all very rounded), call 250lb 100kg. 1,0000 steps a day consumes about 20 kiljoule. If those kilojoules come from eating fat, you either add 1/2 a gram of fat or walk those 1,000 steps.
I know, 1/2 a gram, 0.02oz - almost insignificant, right? Now multiply it by 10,000 and see that over those decades it contributed 50kg of the 100kg we are talking about.
For the same reason exercise doesn't make a lot off difference to a 6 month or even 2 year diet. But when you are trying to explain to difference between trim Koreans and 250lb Americans those extra 3,000 steps a day explain the entire difference, then some.
Its also not really magical, they didn't just add sugar, they added meat, sugar, grains and oil (replacing butter mostly) - all together it adds up to 720 kcal extra per day per capita.
Koreans eat about 1500 kcal less per day (they are also quite a bit smaller on average so it's not 1 ot 1 of course.) Japanese eat even less (like 200 kcal less) but are also even a bit smaller on average. Both countries happily eat terrible food just as much as Americans do these days, they just eat a lot less food in total.
There's an idea that American eat out more and that the calories at dining establishments about increased about 35%.
Only 25% of Americans are getting the recommended aerobic activity. Which is 20 minutes per day of moderate activity (walking).
It is difficult to comprehend how little most Americans walk. In many suburbs, the local store is more than a mile, which would equate to a 40 minute round trip walk. How often do you walk for 40 minutes when you can drive in 8 minutes. Of course, delivery services only exacerbate the issue, as you're not even walking through the parking lot now.
It 100% has to do with walking/biking and portion sizes. Low intensity exercise throughout the day is as if not more effective than high intensity exercise for burning calories and keeping your metabolism from crashing.
Whatever the cause, there seems to be a causal relationship with brisk walking and lower blood sugar the following day.
When you look at ingredient labels in Japan or Germany, you see a short list of what you would expect, plus maybe a preservative.
In the US, you see an entire chemistry lab: artificial colors and flavors, bizarre substitutes for real sugar, oils that a hundred years ago would not be considered fit for human consumption, and so on.
A lot of steps for a pittance of calories [based on whatever hand-wavy math it's doing, admittedly]. We're frustratingly efficient. I forget exactly, it was something dumb like half a candy bar.
I've heard people say "you won't outrun your mouth", in this context... and others.
It's true. I've managed to drop my body weight ~half, it happened by controlling what I ate; not how I exercised. When I stopped skateboarding due to an injury, I ballooned. I stopped eating like that over a decade later, I shrunk.
In that time I also got older, moved, and went to college. It's worth considering what's easier/more likely/realistic to maintain
I strive for 7k steps per day since Covid hit March 2020. Some days I may fall a little short if really tired or sore from golf or coaching little league the previous day, but most days I easily achieve it or go well over. I surely don't think 7k is an unreasonable goal for ANYONE - it just takes a little bit of mentality change and effort that just seem taken for granted in the USA from what I have observed last few years.
Things like parking near the rear of parking lots when going to stores. I am amazed now at how often I see people wasting many minutes in their cars just to wait or "hunt" for closer spots when they could have just parked in back and be walking into the store already. Or parents at the park sitting and reading their phones for an hour while their kids play in playground. Teenagers riding electric scooters/ebikes instead of walking or regular bikes, etc.
I was at my in-laws over Christmas and everyone sitting around eating one of the many appetizers to choose from and drinking alcohol, I decided I wanted to go for a quick mid-afternoon walk just for some fresh air. I remember sort of being giggled at when I asked if anyone wanted to go, with a few bewildered looks on some faces. Again it is a change of mentality that needs to happen if obesity is going to be addressed in the US anytime soon. Now, with these drugs available, I'm afraid it will be even harder to get to the root of the problem.
Even 3000 steps seems low on a regular day. This is what you'd get from just moving around in the house?
So 300 steps is about 3 minutes of walking. If I sit at the computer most of the day and don't leave the house, I might get even fewer steps.
3,000 steps would be about 30min of walking. Perhaps I'm more sedentary than average. Sometimes the only steps I get are walking to lunch and back.
But I got 15,000+ steps a few days ago because I went out dancing ^^
---
edit: also 300/3000 numbers were from my phone, so would exclude steps when my phone wasn't on me.
In my opinion, the Netherlands is definitely a car country.
https://pubmed.ncbi.nlm.nih.gov/30933002/
Americans and Indians just need to move more, weather it’s walking in a city or on a treadmill.
You’re pretty much on track until this. The idea that a specific subtype of sugar has slightly different effects on the body might technically be true, but it’s a small drop in the bucket when compared to the huge increase in calorie intake in general. When this idea started circulating, it seemed like a food company misinformation campaign.
The last time I went to Japan with an American friend, she commented that the portion sizes in Japan were so small. Combined with all the walking from using trains (we'd easily get more than 10k steps per day), we both lost weight during that trip.
Locals would say matter of factly “you only order the large when you want more.”
Also many restaurants offer Tabehoudai and Nomihoudai, “all you can eat and drink” respectively.
All the servers would come to see when the Americans would order nomihoudai and request a pitcher of beer.
“Okay, one pitcher for the table.”
We’d always get a laugh when we’d say, “Actually, one pitcher for each of us.”
It would interesting to see the effect of that here in Australia. Imagine the Homer Simpson at the seafood buffet episode but an entire country.
But exercise has very little effect on weight compared to diet. It's a known fact, even for the fans of counting calories. Just see the tables of inputs and outputs.
Eating less and avoiding sugar and processed food is mostly enough, if not to be slim, at least to keep you reasonable healthy.
Also, some studies suggest that up to some threshold, exercise reallocates those calories from autonomic functions rather than actually adding to total expenditure [1]. It's been further speculated based on this that some of the health benefit of exercise might simply be a result of taking energy away from anxiety/stress responses.
[1] https://pubmed.ncbi.nlm.nih.gov/22848382/
It reduces the weight of all the fat you're carrying around. Even if exercise doesn't make you lighter it still makes you leaner.
I recognize that this is conventional wisdom, but it hasn't been borne out by my own results losing well over 100 pounds / roughly 40% of my body weight over the course of several years.
I've counted calories strictly, with the same methodology and same limit, and documented weight regularly, both during low-activity low-altitude winters and medium-activity, high-altitude summers. The results I got, over the major windows in which I got them, were as follows:
I'm defining "high" activity here as "regularly exercising to physical exhaustion", "medium" as "regularly climbing up hills that cause me to breathe heavily but don't exhaust me", and "low" as "regular walking but nothing that strains my body meaningfully".This is now data collected over years of weight loss and multiple seasonal changes in location and activity, and I find it difficult to explain this within the context of standard weight loss advice. Exercise at altitude seems to burn far more calories than it "should", by a factor of four or five times.
I walked a mile or two every other day on average across this period, meaning the only difference is a roughly 15 to 30-minute walk up a steep slope roughly every other day. A typical calculator will tell you this "should" burn on the order of 100-150 calories, but the data suggests it's closer to 500-1000.
I'm not a doctor, so I don't know why this is. I've largely ruled out:
- Diet, which is conserved across locations fairly well (I cook most of my own food using widely-available ingredients)
- Seasonal effects, unless they happen to produce very sharp discontinuities at the exact time I relocate each year
- Emotional state, since these results have been robust to both positive and negative emotional states in both locations
- Temperature, which is near-constant year round (because I live in warm places in winter and cold places in summer)
- Groundwater, because I drink almost entirely bottled water and not local water supplies
- Major underlying medical causes (my bloodwork is great and I don't have any reason to think I'm sick)
I have a working hypothesis that the studies that established calorie burn from exercise (which I believe largely did it by measuring CO2 exhalation) were missing a great deal of the actual energy cost, because the costs of anaerobic respiration take place over hours following exercise and not just during it. But I also can't imagine people with actual medical expertise haven't thought of this before. A negative correlation between altitude and obesity rates is well-established, so something is going on.
In any case, the data is the data, and it points very strongly towards altitude and exercise, synergistically, being almost exclusively the source of my own weight loss.
Yeah, many years ago as a student I spent a summer in Manhattan. The diet probably couldn't have been more different than Japan, but the combination of walking a ton compared to the suburbs where I grew up, and the fact that as a poor student in a very expensive city my portions were smaller out of necessity (e.g. my snacks were usually fresh fruit sold outside of a store/bodega) I got much healthier.
This is a stark contrast to North America where there are generally no trains to walk to catch, but rather simply a few steps from your door to your car.
My point being that the design of our society right down to the topography of our physical spaces is not set up to encourage walking.
We can’t even agree that obesity is a problem, instead choosing to talk about beauty in all shapes and sizes and other woke nonsense (to be clear: I consider myself a liberal) that masks true objective facts about health.
If we could agree on a goal, perhaps we could then have real conversations about how to get there. But instead we are so fractured and our governments so inept and conflicted that we subsidize the food that makes us sickest.
There are places where it's downright hostile, with areas with no sidewalks or crossings.
> But instead we are so fractured and our governments so inept and conflicted that we subsidize the food that makes us sickest.
There's actually a somewhat sane rationale for the agricultural subsidies. For the longest time in human history, famine was always looming, and the best policy to avoid it was to store excess calories in case of a bad harvest year.
Whether or not that still applies in the US can be debated though.
Intelligent people have died from diabetes and other obesity related illnesses, not because they couldn't understand calorie math or what carbohydrates are, but because they couldn't or wouldn't change their eating habits in the long term.
And Italian diet has a similar simplistic philosophy. French food does not. Both can keep you slim.
“I had learned there are massive health benefits to reversing obesity with these drugs: for example, Novo Nordisk ran a trial that found weekly injections reduced the risk of heart attack or stroke by 20% for participants with a BMI over 27 and a history of cardiac events. But I also saw there are significant risks. I interviewed prestigious French scientists who worry the drugs could cause an increase in thyroid cancer, and eating disorders experts who worry it will cause a rise in this problem. Other experts fear it may cause depression or suicidal thoughts. These claims are all fiercely disputed and debated. I felt trapped between two risky choices—ongoing obesity, or drugs with lots of unknowns.”
The suicidal thoughts have been studied: https://www.nbcnews.com/news/amp/rcna147578
PS: Ozempic is not for weight management, it's for blood sugar control. Wegovy is a higher dose for weight management and not covered by Medicare discriminating against all causes of obesity without nuance.
Did people 70 years ago in the West just happen to eat smaller portions?
>eating sugar in huge quantities.
But sugar consumption, per capital, is decreasing. And has done so for decades, when will obesity rates follow?
All true for Japan though?
I just returned from Japan, and the difference in quality of life due to urban density, reliable public transit, and walkability of every city I visited is staggering. There really is no comparison to the United States. Everything you could ever need to live is within walking distance - seriously. This is the way people are meant to live.
You may have noticed, walking around Tokyo, the lack of children. I certainly do every time I'm there -- I live about two hours away in a bedroom community, where you absolutely do need a car to get around.
Most Tokyo families have one and only one child.
Out where I live, where 1000sqft+ houses are the norm, three or more is not uncommon.
I'm curious about another thing: You mention 1000sqft+ homes being the norm where you're located, is that considered a larger than average home in Japan? I can't find a recent figure for average dimensions of a Japanese home. The average in the United States, by comparison, is apparently 2273sqft (reported in 2021).
ie. Japanese take their trash home from stadium and theaters.
Meanwhile in America we throw the trash out of the window of their car into the parking lot while parked 10 feet away from a dumpster.
I am sure somewhere in Japan there are obese people and those who throw their trash into the parking lot but they are the exception not the norm where it is reverse in America.
But if it takes a drug to help drive down obesity I have no problem with people taking it, but we've got to address the cost which is ridiculous and unacceptable.