Monday, August 31, 2015

Confirmation bias is not just in my head

I've been sent a link to this study:

Body fat loss and compensatory mechanisms in response to different doses of aerobic exercise—a randomized controlled trial in overweight sedentary males

Bottom line: Moderate exercise produces equal weight loss to greater exercise. I'll come back to this later.

I commented in the last post that I consider leaving food on your plate is a very reasonable surrogate for experiencing reduced hunger. This shows up as weight loss. When we look at the converse, long term "accidental" weight gain, my perspective is the same. Eating an extra portion is a surrogate for responding to hunger. Long term hunger = Long term weight gain.

Let's say that again:

Fat people are fat because they are affected by hunger. Not gluttons. Not lazy. Hungry.

If people are going to lose weight on a long term basis they can only do this if they are not hungry. If they are not hungry they will reject food, establish an energy deficit and lose weight.

I may believe in CICO, but that CICO is controlled by hunger.

Back to the study. As the authors, struggling for a moment of lucidity, say:

"However, on the basis of the present findings, we propose that the introduction of a moderate dose of exercise may actually lead to an increase in NEAT without any increase in EI resulting in a “bonus effect,” whereas a higher dose of exercise may lead to an increase in EI and, thereby, a degree of compensation and less than expected loss of FM"

As clear as mud. Let's translate and simplify:

“… a moderate dose of exercise may actually lead to an increase in CALORIES OUT without any increase in HUNGER ... whereas a higher dose of exercise may lead to an increase in HUNGER [ie more eating] and … less than expected loss of fat mass”.

Exercise makes you hungry, certainly if you over-do it.

This is the authors' conclusion. I think they are correct. Other explanations are possible but they if miss the hunger component they are not of a great deal of help to anyone who wishes to understand obesity, even if they happen to be factually correct.



Mike said...

Jibes perfectly with my experience. I recently decided to get a couple of more HIT workouts in to my weekly routine. I am feeling great, but weight loss has stalled as I have become ravenously hungry the day after. As weight loss is less of an objective me at this point, it is not really a problem, other than I have to make sure that I have easy access "good" foods as I find I will binge on the easiest available calories.

Gretchen said...

I think you're right. In my diabetes book, I quote an obese man who was flabbergasted when a thin woman said she didn't want some tempting treat because she wasn't hungry. He said he was ravenously hungry all the time and just assumed that everyone was too.

I think the hunger issue is the key to weight loss.

ItsTheWooo said...

When i was a fat 9 or 10 year old child i knew i was "genetically fat" because i never became full after eating like thin kids, and i got hungry very quickly. I remember being this small watching talkshows for women like Oprah where they talked about "emotional eating" . I remember thinking "No, i know i am physically hungry".

When i was 20 i learned all food is not the same and insulin is the thing that drives the abnormal hunger.

I'm going to be 33 and i've been thin since.

Woo: smarter than overpaid professionals since about 10 years old.

ItsTheWooo said...

The real question/fascination to me is how readily fat people, particularly women, are to accept their hunger is fake or emotional. No, you're hungry. Thats why you're eating. When you are less hungry, you eat less on average. It's really that simple.

I suspect so many fat women hold on to the naive hope that they can use willpower, planning or magic beans to be skinny , accepting they are eating tons because their body is making them gain weight an unacceptable conclusion.

The irony is their CICO dieting is the cause of the new adipocyte growth and compensatory hunger/binging after every starvation bout. Many of these women, now deformed little trolls that mock GT from anonymity, refuse to even show a photo. They are like stockholm syndrome defending the starvation practices that have rendered them squat deformed gollum like caricatures . Still cling to their "precious", the dieting/starvation/CICO paradigm in spite of being too obese to show a photo.

IMO, these anonymous CICO warriors - all fat women who dieted their way permanently obese - should show their photos. Like "faces of meth", the massive obesity on very little calroies is a testament to the horrors of what CICO will do to a person if coupled with rebound insulinogenic building over a few decades.

There is no better argument against Hall.

Meanwhile, people with endogenous metabolic disorders like myself have an opposite path. We discover, sometimes, targeted insulin/metabolic/endocrine control and arrest and reverse a tract of brain and body damage. I am now effortlessly thin , no matter what haters might say. I dont weigh myself, i dont restrict calories, and i dont abuse drugs unless you consider glucophage a drug of abuse, or various vitamins/minerals/plants less tolerance forming than simple coffee.

I would also mention i was maintaining a low wt well before using those things; difference is the addition has made weight control TOTALLY effortless.

Anyway, its all very amusing to me. CICO stockholm victims, too f*cking fat to show up in public as a DIRECT RESULT of starve-binging their way to piles of adipocytes, mocking the very therapy that saves individuals who have real primary metabolic disorders (like me). Our stories are literally opposite, and a testimony to the correctness of metabolic disorder hypthesis/insulin control as a therapy. It's so amusing and ironic.

Anonymous said...

I blame Oprah, women's magazines and the pop psychology/self-help cult spreading rancid lies about weight control. As Woo said, it's always been fairly evident to me that women (generally women) cling to the myth of willpower/CICO/emotional eating so that they can maintain some semblance of control and hope in what is otherwise a horrifying & essentially hopeless situation of having a disfiguring and stigmatising metabolic disorder which will ruin your life, career, marriage etc. prospects.

Galina L. said...

I used to be sure since being a little child that being excessively hungry was my personal defect, my mom was the same.There is another feature of such condition - most foods taste absolutely amazing(I remember being the only child in a daycare who liked being given a cod liver oil by a spoon), and a lot of brain power is delegated to thoughts about food. It was very strange for me to read in people's comments that binge eaters binged not because of their abnormal hanger but for some another reason.
I am loosing weight (a vanity pounds) complitely effortlessly at the moment after my doze of desiccated thyroid was changed to be sufficient enough to bring TSH very close to the low border of normal. I am glad I can skip fasting couple times a week and eat more now.
Absolute majority of the people who are naturally lean are sure it is the result of them being a better quality individual with superior discipline. They just have no idea how torturous an abnormal hunger can be. Most of such super-humans start to develop a skinny fat appearance as they get older, but still normal BMI usually keeps their sense of a superiority intact.

PhilT said...

Personally an excess of exercise leads me to fall asleep on the sofa, so the EAT is cancelled out by a reduction in NEAT.

henry the fifth said...

I believe entirely in hunger being the driver for overweight. I have a friend who can sit down and eat an entire tub of ice cream and possibly a packet of biscuits...all after a main meal! If I was to sit down and eat an entire packet of biscuits , even when hungry let alone after a meal, I simply would fail, or vomit. I'm slim...he isn't. My appetite drives the amount that I eat and it is obvious that my hunger is sated long before his is. Curious how peoples appestats vary so much.

Passthecream said...

Woo, I started to balloon at the same age, 10 or so, and by the time I was 14 I weighed 14 stone. The genetics are blatant - I have a sister who grew up eating the same type of food who is petite, actually as skinny as a rake - if she stood sideways and stuck out her tongue she'd look like a zipper. I have a completely different build and can/could/did eat anything put before me. A whole packet of biscuits was easy for me but my sister would only have one biscuit. It's a twin - evil twin experiment. My constitution must have been robust at the outset since it held up under the ravenous onslaught for a subsequent 40 years until it started to go awry. But the appetite is still there lurking, for the hard times ahead, perfectly tamed without the flour/sugar/beans/potatoes and etc.

I have always thought of appetite as HEALTHY, not tragic. Emotional? What are you talking about?


Anonymous said...

Prior to reducing carbohydrate intake, I used to suffer debilitating confirmation bias.

Or maybe it was Dunning-Kruger.

Broccoli overload?

Can't remember. Doesn't matter, the point is that now I am truly fantastic and brilliant. All the people I surround myself with say so.

Peter said...

Ah ha! Glucose deficiency blocks the ability to perceive glucose deficiency induced brain fog. We're all fuched...

LeonRover said...

"We're all fuched..."


I know I'm foxed . . .

karl said...

I buy into the results of this study, but what is missing is the understanding that there are different types of exercise.

Before I had built my own weight room, I used to go to the gym and see these poor people desperately trying to lose weight. They would be there everyday - walking on tread mills for over an hour - and they were failing. Breaks my heart to see.

I've looked at a lot of exercise studies and exercise programs just don't lead to lasting weight loss.

Now that does not mean that one should not exercise - gaining muscle mass (and bone/tendon strength) has great health benefits but the standard advise of the medical community - low impact exercise - is misinforming people. Rippetoe had a humorous bit on this just the other day.

Telling people that by waving their arms they are getting meaningful exercise is actually harming them.

The key bit that I have realized - it is important to get the most benefit for the time spent - and the methods to do that are weight lifting(Rippetoe) (by doing squats 3 times per week - 5-sets of 5 - At 60 years of age I went from a max of about 80lB to 190lb in 6mo - reduced my fasting BG from the mid 90's to 85. )

The other method is sprints - either swimming or running - All out for 30sec - rest - recover heart rate - Repeat 3 times - 3 times/week. (Sprints are important for cardio/pulmonary fitness)

Between these two methods - little time is used and great benefit archived.

But we are back to the question - what is causing the great obesity pandemic of our time? I think it has multiple causes - likely causes:

Excess consumption of monocotyledons - carbs/sugar

PUFA consumption

Xenoestrogens from plants and plastics.

Notice my list does not have lack of exercise - sedentary people can be thin and Type2 -very weak - etc.

raphi said...

Gretchen said: "Absolute majority of the people who are naturally lean are sure it is the result of them being a better quality individual with superior discipline. They just have no idea how torturous an abnormal hunger can be. Most of such super-humans start to develop a skinny fat appearance as they get older, but still normal BMI usually keeps their sense of a superiority intact."

I'm naturally lean and until a few years ago had full-on confirmation bias that I was not a glutton & overweight people were. It's embarrassing, perfectly common & true alas.

It's (strangely?) freeing to realize that health is not about character but about biology. The potential for improvement is provided once this is realized.

STG said...

A few years ago I had a bad injury and I could not exercise and was stuck in my house except for PT. I had to force myself to eat and I had no hunger. I loss a lot of muscle mass and it was a long recovery before I was hungry again. When I could exercise again, my hunger returned and I started gaining weight. Does this study apply to my situation?

LA_Bob said...


Actually it was Galina who made the "Absolute majority" comment.

I am one of those "better quality" individuals who exercised "superior discipline" to starve myself down to a few pounds underweight (and probably somewhat malnourished) on a "low-fat" but increasingly higher sugar diet. I was essentially hungry all the time. I have always been slender, but I had put on ten pounds or so in early middle age.

It was a random blood sugar test that gave me a clue something was radically wrong with my approach. Not that my sugar was all that high, but it was higher than I expected and liked. This was almost seven years ago.

Fortunately, I had stumbled across Gary Taubes's "Big Fat Lie" article. I later read his book and made the switch to low carb. Now I am much "better quality" than in my low-fat days and still slender in a much healthier way.

I also credit Taubes for getting me, eventually, to Peter's blog, and with my new-found exposure to his thinking I am even more "better quality" than ever!

Sam Knox said...

There is hardly anything better established in the literature of exercise physiology than this: Exercise is a piss-poor way to lose weight.

Galina L. said...

To Sam Knox,
Exercising while having an excessive weight is a well-established cause for sport injuries. I can't stand pictures of fat people in training to run marathons. In reality they just dramatically increase their chance to need a knees replacement.

M. Levin said...

I hope you're not one of those people who get bent out of shape when their grammar or spelling errors are pointed out, but in the following passage it appears that that IF and THEY are reversed.

"This is the authors' conclusion. I think they are correct. Other explanations are possible but they if miss the hunger component they are not of a great deal of help to anyone who wishes to understand obesity, even if they happen to be factually correct."

I seem to recall that in Taubes book "Good Calories, Bad Calories" he makes the point that the low carb diet studies done by the Germans in the 1930's did not involve an exercise component.

Peter said...

Hi M,

No problems with grammar and typos. I do agree that there are a lot of "they"s in there. Not the neatest phrasing but I think it does say what I meant to say...


Unknown said...

Whenever I resume vigorous exercise I get extremely hungry and eat everything in sight. This last a few weeks, then my hunger normalizes. I figure it is my body rebuilding itself and I need the calories. The weight drop comes later. If I freaked out at the initial weight gain I would never get the long term drop in weight and increase in muscles.

Unknown said...

Hi Peter----I wanted to contact you about this study---

I think we need your expertise here.

thanks Errett Bradford-----

Peter said...