We're All Deluded About Food & Obesity

On weight loss drugs and barking up the wrong tree

“Pass the margarine,” I say to the man across the table, and he hands it over with a smile.

Then I punch him in the face.

“This psychopath just gave me exactly what I asked for!” I scream so every diner can hear my outrage. “What if he’d given that margarine to my defenseless child? Are we going to stand for this?”

Most look up from their chicken fried steaks and nachos in confusion. “Yah,” one says. “It’s tasty.”

But some glance past their Pringle cans, surveying distended bellies. “Tell um, brother!” they yell, raising meaty fists into the air. “They can’t get away with giving us what we want forever. Not if we unite!”

All the while, a group of slim people in the corner sit around eating moderate portions of good-enough-tasting food, looking confused, while an even smaller group of slim people feasts on junk food and looks even more baffled.

This is our paralyzed discourse as diabetes, obesity, heart disease, and cancer run rampant and Western civilization increasingly sinks into disability.

As a former obese person who professionally offered health and dietary guidance to clients for more than a decade, one thing is clear to me — blaming our “food environment,” “lack of education,” “or lack of resources” is nonsensical. It’s stopping us from addressing the heart of the matter.

The topic I’d like to explore: The cause of our obesity and healthcare epidemic has its tentacles in many of the crises Western society is wrestling with. If we’re going to make an impact we’ll need to face the elephant in the room, and people are going to hate it.

But first we need to grapple with the common obesity and food misconceptions. So in this piece we’ll explore those misconceptions, with a possible solution to follow in the next.

Too Ignorant To Eat?

“…the pleasure of food is undoubtedly the most difficult of all pleasures to combat.”
— Musonius Rufus, Lectures and Sayings, 73, 1st Century A.D.

Average people know little of nutrition, but talk to them about food and it becomes clear they know enough.

In a decade of working with sick, overweight, and obese people:

• I never met someone who thought French fries were better than broccoli.

• No one was surprised to learn guzzling 13 ounces of soda a day was harming them, or that water, plain tea, and black coffee were healthier choices.

• Each recognized their inability to moderately eat heavily processed foods.

• No one thought food became healthier after a dip in a fryer vat.

• They understand the correlation between calories and weight.

In my work I created diet plans, shopping lists, and recipes that helped lots of people slim down. Many clients brought autoimmune conditions into remission and got off insulin. But I quickly learned my nutrition and health knowledge was of secondary importance.

Eighty percent of my clients most needed help coming to terms with abandoning dietary hedonism for the mild diets our ancestors thrived on for millennia. For many, saving their lives was a poor trade for less pleasure. Some things are worse than death, seemed to be their unspoken position.

In the beginning, this surprised me. The media bangs the drum of nutritional ignorance and our inescapable slop food savannah as the cause of poor eating. Talking heads insist providing knowledge and access to healthy options will be enough, but it rarely was in my practice.

And when I took on pro bono clients from among the poorest Americans, another thing surprised me — only one person thought their "food desert” impeded healthier eating. And after I explained that they didn’t need expensive, organic, "Whole Foods-style” processed junk to be slim and healthy, none considered lack of means to be an impediment.

Access:

“The size of the body is increased by eating sweet and fatty substances, as well as by drinking…” — Pliny, Natural History, 11.118

Food Deserts Explain it all!

America is a barren waste of gas station slurpees, 10-year-old twinkies, and room-temperature pizzas marooned in grease. It is known. Food deserts appeared, and then came obesity, the thinking goes.

Except it clearly didn’t happen that way. Multiple¹ studies² find proximity to supermarkets doesn’t affect fruit and vegetable consumption.

And when you add³ supermarkets⁴ to low-income neighborhoods, fruit and vegetable consumption doesn’t increase, nor does obesity decline. So much for food deserts.

Poverty is another obesity boogieman, but at least until the CDC stopped collecting income data in their obesity research in 2014, the poorest Americans were slightly less obese than middle-income Americans⁵. And even the highest-income Americans are shockingly likely to be obese, on average

So what, then? Do we need to blame “the system?” Might evil corporations hell-bent on profit at all costs be to blame?

Blaming The Giver:

“Once food started to be sought not to relieve hunger but to arouse it, and countless seasonings had been discovered to stimulate gluttony, what used to nourish the hungry began to burden the overfed.” — Seneca, Letters, 95.15

Capitalism holds a mirror up to society and reflects our desires back at us. If something ugly is on offer in the aisles of your grocer or on the diner’s menu, you should know who put it there. It’s us.

Capitalism isn’t a perfect system, but blaming “greedy companies/CEOs” for our food problems is inane. Yes, corporations are driven by profits and not altruism, but not in the conspiratorial, Machiavellian way people assume.

We hear about dastardly food scientists constructing addictive foods. And we do have an overwhelming body of data demonstrating that processed food leads to greater caloric consumption and weight gain than unprocessed foods. Eating them makes it much harder to avoid obesity.

But corporations are primarily driven by quarterly earnings, and are largely responsive to our desires. They frequently make “small bets,” to test what “today’s consumer” wants. We see their small bets play out in real time.

• Remember when McDonald’s did the salad and healthy food experiment? It was quietly ended during COVID. As CEO Joe Erlinger explained, the healthy options were discarded because they didn’t sell. It turns out no one wanted healthier food. McDonald’s launched big advertising campaigns and made better options as accessible as possible, but Americans ignored them.

• Remember when plant-based meats were all the rage a few years ago? Dunkin, McDonald’s, Pizza Hut, Panda Express, and KFC all gave it a shot and then discontinued these items when it turned out no one wanted them.

• Have you noticed companies scrambling to see if Americans losing muscle mass on Ozempic will pay for higher-protein junk food? We’ll have to see how that plays out.

What this tells us is that giant corporations are desperately trying to learn what we’ll pay for. Not what we say we want, not what experts claim we need, but what people actually open their wallets for.

The answer is clear — the majority of Americans will pay for pleasure maximization, not health maximization. Health maximization is a tiny niche filled by niche food manufacturers and restaurants.

Processed foods do cause overeating. Maybe we should call them addictive. And yes, they’re profitable. But what we’re addicted to and what they’re profiting from is pleasure.

• Dehydrating concentrates flavor and makes foods more pleasurable to consume.

• Add salt, sugar, and fat to almost anything and it tastes much better.

• Manufacture crunchy exteriors and soft interiors (fries, cookies) and the brain’s pleasure centers light up.

Companies have learned to do these things not because they’re addictive, but because they’ve followed the breadcrumb trail of dollar bills to its conclusion. After repeatedly trying healthier offerings, they’ve learned that healthy can’t beat pleasure in a fair fight.

And what about obesity-promoting toxins in our food and environment?

Should we blame big businesses for those?

It’s a subject worthy of its own deep dive, but there is evidence that higher plastic pollution affects us hormonally and is linked to weight gain. But here’s the thing — we started getting fatter way before the mass rollout of plastics in the 1950s, as we’ll cover next. Most plastic pollution (90% +) gets into us through food⁶, and people fasting for 48 hours see their plastic levels plummet⁷. The lion’s share of the plastic pollution in our food comes from heavily processed and canned foods, the same stuff that was making us fat before the plastics. Disentangling the exact contribution of plastics is challenging and unlikely to be solved soon.

Luckily, we can kill two birds with one stone by avoiding the heavily processed foods that fatten us regardless of plastic content.

Anyway, we need to stop blaming restaurants and food corporations because they’re doing our bidding and handing over what we ask for — cheap pleasure. If McDonald’s “took a stand,” and started serving only healthy foods, they’d be out of business in a few years, outcompetes by businesses more interested in serving what people will buy.

And if you think our current form of government is going to meaningfully tax or regulate away tasty food to the extent that we could get out of this mess, keep dreaming.

Let’s concentrate on where the hope is.

Food Drive

“Since [gluttony] is very shameful, the opposite behavior — eating in an orderly and moderate way, and thereby demonstrating self-control — would be very good. Doing this, though, is not easy; it demands much care and training.”
— Musonius Rufus, Lectures and Sayings, 18

My girlfriend is — hedonically — a rare beast. Effortlessly lean, she abandons meals she loves after small servings because she tires of them. Yet she snacks not only between meals, but between snacks — much of it processed food that would drive me straight back to obesity land. She can eat a few of anything and stop because she’s bored. I would pile drive those snacks down my throat until the bag was empty if I gave myself free rein. Many of you know what I’m talking about. It seems unfair, and differing reactions to food pleasure explain why many people are baffled by obesity. They don’t understand that our vulnerable brains focus on pleasurable processed food like searing spotlights in a dark room. They dominate the mind space.

If we sent her back in time, I suspect my girlfriend would become one of those gaunt-faced 19th-century factory workers peering out from grainy heliotypes. She just wouldn’t find enough stimulating, pleasure-giving food to keep her from wasting away.

She falls on the lowest BMI centile curve, which has barely budged since 1880 while the upper ones have skyrocketed⁸. People like her have always been around, and they’ve escaped the processed food revolution almost entirely unscathed. They’re deaf to the siren call drawing the rest of us toward the rocks.

Go back to any point in the past and you’d find plenty of people who were more food-pleasure motivated and prone to overeating, and so slightly heavier, but the food on offer — for the majority of people most of the time — was inadequately pleasurable to push them into dangerous territory.

What determines food pleasure-seeking? Researchers call it food drive.

Some are born with genes that change our responses to dopamine, salt, sugar, fat, and other factors of food pleasure, but environment, social habits, and stressors play a role too.

When enough of these factors stack up, really pleasurable food becomes irresistible.

Peasant Food

“Plain fare gives as much pleasure as a costly diet, when the pain of want has been removed, while bread and water confer the highest possible pleasure when they are brought to hungry lips.” — Epicurus, Letter to Menoeceus

The fatty American diet reduces our brain’s responsiveness to food pleasure, forcing people to eat more and more of it to get the same pleasure hit, like a junkie.

Even simply eating high-fat, high-sugar snacks makes low-fat, low-sugar snacks unsatisfying⁹. But a study on water-only fasting found abstinence from these foods provides much of the fix¹⁰:

”…10 days after the start of the fasting, salty taste recognition, sweet taste detection, and sweet taste recognition thresholds decreased significantly, salty taste intensity ratings increased significantly, and sweet taste intensity ratings decreased significantly...refeeding on an exclusively whole-food-plant diet may reduce salty/fatty and sweet/fatty food liking, reduce sugar intake, and increase vegetable intake.”

In other words, plain foods become tastier and unhealthy foods less appealing the longer you stick to healthy food.

When helping obese and binge-prone clients, I often played the “pick a peasant, any peasant,” game where they could choose their favorite bland peasant staple (potatoes for the win!) and eat it in unlimited quantities for two weeks without sweeteners, fat, or salt.

The first few days were often rough, but after a week they frequently told me their relationship with hunger and eating was completely changed while the fat was falling off. They just weren’t that hungry anymore. They then started broadening out their healthy food menu and taking “small” pleasure bets to see if, for instance, pinches of salt or some avocado would bring back craving and binging.

The problem was that numerous clients found they couldn’t stray far from “healthy monotonous peasant food,” before cravings returned and they were back to white knuckling it all the time. They couldn’t bear eating “fine” but not exciting food to stay slim, and many couldn’t bear being deprived of food pleasure.

Their ancestors thrived on these simple foods for millennia, but not even a healthy, slim body was compensation enough to go back to them for many people.

It’s enough to make you throw up your hands in despair. I sometimes did till I started finding some better techniques.

Which is why it’s no surprise that weight loss drugs appeared on the scene.

What If Pleasure Didn’t Exist?

Modern medicine and the abundance to afford it are amazing, so I cheered the role out of GLP-1 receptor agonists like Ozempic.

If you’re 300 pounds and dying, or you’re going to lose your foot to type 2 diabetes, then go for. Do what you have to do to stay alive. You’ll get no shame from me.

But, if we, as a society, think this is some sort of magical cure-all everybody with weight problems can embrace, I think we’re going to be disappointed.

These drugs don’t just affect our stomachs — they hack our brains, changing our drives and emotions far beyond the dinner table. Whatever brings pleasure can be affected by these drugs¹¹.

A study of 162,000 obese people found Liraglutide and Semaglutide use led to a ~98% increase in psychiatric disorders, including a 195% higher risk for major depression, 108% for anxiety, and 106% for suicidal behavior compared to controls¹².

Check social media, and for every person celebrating their weight loss, you’ll find others bemoaning personality changes and the loss of the pleasures they once loved.

Yes, you want to lose weight, but do you want to lose your personality too? The drives that make us want to pet our dogs, embrace our lovers, pursue hobbies, and achieve things also make us seek pleasurable food.

A world of Ozembic humans will be flat and grey.

Ozembic might help save your life. Hopefully, people will use it as a scaffolding for transitioning into healthier habits. But I suspect most won’t. When people go off these drugs they start to regain their weight, which means that they’ll need to stay on them for life or continuously cycle up and down in weight as they go on and off them.

The shitty, low-protein diets people eat on these drugs may be devastating — 40% of semaglutide weight loss comes from muscle mass, not exactly an outcome that will lead to long-term health¹³.

So what’s the better option? I’ll pick that up next time.

Until then, you might want to check out my general food advice:

I Was Obese. Here's The Food Advice That Keeps Me Sane

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