SAM FELTHAM IS MY HERO

So this guy did this N=1 experiment where he ate 5,000 calories per day for 21 days. It appears he followed a VLC rather similar to what I eat. Surprise to no one except perhaps an obesity researcher, Mr. Feltham's weight only increased 1.6 kgs, and his waist circumference actually declined, suggesting he assimilated virtually none of this excess food as body fat.

Looking at Sam Feltham, he appears very obesity resistant naturally (lanky and tall) so I doubt he could put on much body fat even eating total garbage. These experiments have been tried before in highly obesity resistant people, and they invariably end the same; whether they eat chocolate cake or whether they eat bacon: naturally obesity resistant people CAN NOT store much body fat; they retain grossly less body fat than anticipated, if they store any at all.What I find most interesting of this experiment is not that Feltham didn't gain (that is what I predicted), but I find it most interesting that  Feltham actually managed to eat 5000 calories every single day of a ketogenic diet. In most over feeding studies the participants become so nauseated and repulsed they vomit and simply can't make their calorie goals every day... and that's utilizing easier to store foods like sucrose that spike insulin.
It is just as hard to over feed every day, as it is to under feed every day. Sure, today I can probably eat 1000 calories, or 4000 calories, but tomorrow I assure you I am going to auto-correct. I would love to ask if there were any nausea/vomiting episodes or close calls?

Anyway, the reason I am giving shout out to him is because he's advocating the insulin hypothesis / controlled carbohydrate intake to attenuate pathological fat storage and for that I send BIG SUPPORTS. It's so rare to find a person with no vested interest in this thing who "gets" it and I support all of them. He does have a diet book business , but no personal history of obesity or diabetes. His insight is commendable. I also really liked his personal anecdote of being mis-diagnosed with cancer as a child, and he might have died if not for the fact his mom defied doctor's orders. I also had a similar experience at 16 and I too credit this for my skepticism (or insight) into the tremendous weakness of conventional medical advice or "experts" opinion.

I like his "limescale" anology regarding how the endocrine and nervous system dynamics of the obese individual promotes gradual accrual of body fat in adipocytes culminating in obesity. This is a good, non technical, non jargonish way to get the message across to medical info allergics. Unfortunately, in taking this approach he leaves himself open to attacks from Big C, whiny Guyenet, McEwen, et al. ...but who really cares. If even 1 chubby grandpa stops eating crappy carbs and sugar after reading this, IT IS TEH SUCCESS, and worth the steam coming out of Kocur's ears.

Here is a sample menu. Hard to imagine this was 5,000 calories though, unless he added JMesque portions of butter ;)

Breakfast – Scrambled eggs with salmon and green beans
Snack – Walnuts
Lunch – Mackerel with green beans
Snack – Pecans
Dinner – Topside beef steak with green beans
Snack – Almonds

Meh! I will always support a sane low carb diet w/o gimmicks wherever spotted! Double bonus points if the person has insight enough to see this w/o first hand experience.

The physiology of body fat regulation: LEPTIN, control of endocrine system, mesolimbic dopamine, PNS/SNS.

If you only understand one thing about body fat regulation let it be this: LEPTIN.

More than any other endocrine or nervous system factor, the adipocyte hormone leptin exerts master control over adipose. When people speak of "the set point" what they are largely describing is leptin level vs responsiveness. Leptin is a veritable orchestra conductor of the entire endocrine and nervous system as pertaining to body fatness and composition. It affects almost every single organ in the body, the entire nervous system and endocrine system.

Pictures say a thousand words, so here's a graphic to illustrate.

This graphic describes how adipocyte leptin affects the brain and subsequent hypothalamic hormones, neurotransmitters, etc. Note this is by no means a comprehensive graphic (lots left out) but IT GETS THE MESSAGE ACROSS. (Edit: I would like to make clear I disagree with the conceptualization of obesity as being redundant with starvation entirely, a concept this illustration seems to depict via the "blocking" of leptin at CNS during obesity; all the same it still serves a good visual representation of how fat tissue ultimately controls the brain and physiology via leptin).

 

On the bottom of the graphic you see a representation of adipose tissue (either large/hypertrophic on the right, or atrophied/hypotrophic as on the left). There is also a visual representation of leptin output (either plentiful or diminished). On the left side, you see a representation of weight loss/starvation and relative hypoleptinemia, and on the right you see a representation of minimally adequate adipose and adequately strong leptinemia.

I love this graph. This is a fantastic illustration of how our adipose tissue exerts primary control over body weight and the CNS, contrary to what that dummy Guyenet would lead his followers to believe. Certainly the CNS controls weight, but it only does so only and always after the body fat tells it what to do.

Leptin exhibits effect passively via exerting a suppressive effect on energy conservation systems; it's presence doesn't do all that much extra, but lack of it does a whole , whole lot wrong. This is why supraphysiologic leptin doesn't help all that much to antagonize metabolic disorders and obesity, and leptin injections fail to cure obesity; extra leptin in humans doesn't powerfully drive up energy wastefulness, but declining leptin from starvation or weight loss does a TON to increase body weight. Obesity is caused by defects that are outside of direct leptin signalling. This appears to be a major logical error Stephen Guyenet has in understanding obesity; in prior correspondence with him I tried to illustrate that obesity is not a condition of leptin resistance, because functional leptin does not necessarily "cancel out" the obesigenic pressure of any pathologic condition that would otherwise cause obesity (e.g. extreme hyperinsulinemia, or very weak SNS). He simply could not conceptualize this , he could not understand how it could be true that leptin signalling might be grossly in tact but a pathology isolated from leptin signalling might still drive obesity. I think Guyenet's inability to think in non-binary is a great example of his lack of creativity, imagination, and the state of obesity research in general.


In the center of this graphic are various brain regions that are sensitive to leptin and WHAT HAPPENS endocrine-wise when the leptin signal becomes more like the left side; diminished. Please note all of these changes work to either conserve energy use, increase food retention as body fat, or increase food seeking/eating behavior. A weak leptin signal is screaming to your body: YOU ARE STARVING TO DEATH.

• GnRH pulsality declines. Pituitary LH/FSH is not normally produced. The gonadal axis becomes arrested as if in a prepubertal condition; in fact, leptin naive humans will never enter puberty until they start leptin therapy. Leptin deficient women develop hypothalamic amenorrhea and infertility. Men develop loss of libido and low testosterone. One of the most energy wasteful physiologic functions is reproduction, after all.



• TRH declines. Pituitary TSH does as well, leading to diminished output of peripheral T4/T3. this is contributing (but not totally causing) euthyroid sick syndrome, the physiological faux-hypothyroidism that has become epidemic self diagnosis // false dx made by "naturopaths" such as $$$Kresser$$$.  (SECRETZ: The cure for euthyroid sick syndrome is a small wagon of steak, avocados, butter, sleep, and sometimes weight regain. Carbs need not apply/required, it is a leptin/SNS driven phenomenon secondary to negative energy imbalance.)



• CRH increases. Pituitary ACTH also increases, stimulating adrenal gland cortisol. ACTH is cleaved from proopiomelanocortin (POMC) and this deficient leptin mediated change promotes greater activity of adrenal glands and an energy storing state. Higher cortisol levels promote adipogenesis and glucose intolerance, fatigue and emotional malcontent , insomnia and hunger. In general the POMC antagonizes obesity, but it is like a chameleon; so many things in physiology exert both agonist and antagonistic activity depending on some secondary modulator. In this case, a lack of the leptin signal switches the POMC to a highly stress responsive energy conserving/food seeking condition. When the leptin signal is strong, POMC is activated to promote energy waste and anorexia via MSH . (Aside, people with primary adrenal failure exhibit signs of skin hyperpigmentation and anorexia because the non-functional adrenal gland powerfully drives up POMC; to make more ACTH in response to diminished cortisol from a non-functional adrenal, more MSH is produced as a byproduct, leading to lack of ability to store fat/profound anorexia and characteristic skin hyperpigmentation).



• AgRP/ NPY are potent orexigenic signals which are disinhibited and elevated by  a lack of leptin signal. 



•  The mesolimbic dopamine system is partially leptin-dependent. An adequate leptin signal is required for normal dopamine sythesis storage and release. Dopamine exerts independent effects on food eating behavior, appetite, movement, energy, and glucose/fat oxidation changes. The general effect of dopamine as pertaining to body fatness and eating behavior is that of potent suppression and energy wastefulness.
   
  More than any of his other deceptions, I resent Guyenet most for his brazen misrepresentation of dopamine in obesity. The ascetic, anoretic, puritanical Guyenetican conceptualization of dopamine as an arbiter of hedonism and consequential obesity is so polar opposite of reality. The thing is, his entire food reward hypothesis pivotally rests on this lie and ignorance; even a minimally adequate understanding the physiology of dopamine signalling with regard to body weight regulation rapidly dismantles "food reward" for the hilarious joke it always was.  

It is most accurate to characterize dopamine as a powerful neurohormonal modulator promoting energy wastefulness. Its presence signifies an energy rich environment with good prospects. Subjective human behaviors associated with "dopamine" and "addiction" like "risk taking behavior" or "impulsivity" or "reproductive interest" or "hedonism" are merely behaviors which would be adaptive in an energy rich environment with good long term prospects.  "Addiction" is certainly a disease related to dopamine, but typically requires a substance of abuse that can drive dopamine quite powerfully. Food does not quality as a drug of abuse capable of wild dopamine disinhibition. Obese people exhibit an exaggerated dopamine response to food but this is secondary to the low dopaminergic tone that is actually causative of obesity; low basal dopamine release, low sensitivity, and general thrifty energy conserving phenotype. It results in behavior that prioritizes eating behavior and food seeking before other activities.

The entire food reward hypothesis rests on this pivotal misunderstanding of dopamine.  A lack of sufficient leptin signal in the brain decreases mesolimbic dopamine stores and basal release. Obese people are actually dopamine DEFICIENT, and a low dopaminergic tone prompts heightened responsiveness to food eating behavior amongst a myriad of other low-dopamine energy conservation symptoms (e.g. psychomotor retardation, lethargy, lack of motivation/anhedonia, hypersomnia, glucose intolerance and hyperinsulinemia). The greater responsiveness to food stimulated dopamine release which is observed in obesity does not mean eating is an "addiction" for obese people, it only suggests low dopaminergic tone is yet another leptin mediated mechanism to promote escalating body fatness; low basal dopamine mediated hyperphagia is just one of many ways this is accomplished.

Furthermore, the bulk of evidence from both animal and human examples suggests that a low dopaminergic tone is a component of virtually all naturally occuring energy conservation states. When we block the D2 receptor in humans, it is expected they will develop glucose intolerance, obesity, and sedentary behavior. Animals about to enter hibernation exhibit a phenotype very much like human obesity, and it is triggered by seasonal downregulation of D2 receptors and escalating melatonin levels in response to seasonal sunlight (dopamine and melatonin exist on an axis, and serve polar oppositional effects on physiology). If a hibernating animal is given a D2 agonist, they will not enter hibernation. When diabetics and obese humans are given D2 agonists, they actually tend to have superior glycemic control and body fat reduction. Many obese people, such as myself, exhibit a fairly profound seasonal effect of body weight; people in environments with a great deal variation between the summer and winter may shift body weight up or down 5 pounds secondary to this dopamine/melatonin axis effect. To attribute this to "addiction" is a gross lie or an overwhelming stupid misunderstanding. Either way it is critical and entirely dismantles whatever legs the FR hypothesis had to stand on.

• BDNF is demonstrated to be reduced by a diminished leptin signal. While this plays a minimal role in the physiology of weight regulation, it explains why starvation promotes mental illness in "dieting" women, and may explain why bouts of starvation population wide are sometimes related to onset of mental illnesses such as schizophrenia and depression. During the minesotta starvation experiment, significant mental decompensation was more the rule, not the exception. As with everything pertaining to weight regulation, medicine seems to have the causality reversed when it comes to disordered eating and mental illness. Restrictive eating and chronic starvation CAUSES mental illness, not the other way around.  BDNF is crucially implicated in the maintenance of healthy brain; pre-treating rodents with leptin and exposing them to stressors is shown to be prophylactic against depression and stress syndromes.(Speaking personally, I strongly feel 2 years of semi-starvation eating worsened my mental health condition, and I feel 3 years of  leptin from drug therapy reversed that trend.) Leptin is a highly effective therapy for depression and virtually all mental illnesses by way of augmenting BDNF and regulating the HPA axis by reigning in CRH/ACTH and cortisol production.



• Brainstem/NTS affects sympathetic vs parasympathetic dominance of the autonomic nervous system. It affects how we process consumed food; in general, PNS dominance affects gastric peptide secretion so as to facilitate exaggerated insulin reactions, enhanced gastric motility/rapid absorption of nutrition, lethargy, and subsequent energy storage, hypoglycemia, and hunger. PNS vs SNS tone cannot be emphased enough as critically important in the etiology of obesity, particularly "metabolically healthy" obesity w/o much insulin resistance or hyperglycemia. More than any other aspect of physiology, when it comes to pathologic obesity the SNS would most accurately be defined as insulin antagonistic (glucagon is often cited as "insulin antagonistic" but this is really only true in regard to diabetes/ blood sugar; when speaking of body fatness, the SNS is insulin antagonistic, not glucagon). Leptin signal exerts a suppressive effect on the PNS, while simultaneously normally augmenting the SNS to promote leanness.
  
  The SNS is powerfully leptin controlled. Understanding this can explain why fat people are fat, and why dieters stall after losing weight, et cetera.  This is a huge topic in of itself, and I intend to go into greater detail in the future when I blog about the SNS wrt weight regulation.

The above graphic only scratches the surface of leptin mediated effects, but as stated, a picture speaks a thousand words and all of my rambling elaborate detailed explanations are sumarized in the blink of an eye above. This is "set point" in a sentence: Strong leptin signal secreted from adequately sized adipocytes; energy conservation systems are then terminated and body weight stays in equilibrium.

 -------------------------------------------------------------

 TL;DR:
1) Leptin exhibits its effect via terminating energy conservation feedback loops, which otherwise operate unopposed when the leptin signal is too weak.

2) Supraphysiologic leptin does not result in extreme leanness in normal individuals; it merely maximally terminates the energy conservation systems of the body. Leptin exhibits a largely passive effect over weight control. Obesity rarely implicates leptin signalling directly as a point of pathology, which is why very high leptin secondary to hyperinsulinemia is insufficient to prevent obesity.

3) Leptin exerts master control at the hypothalamic level of every endocrine axis in the body. Leptin largely controls the function of insulin as a fat storage hormone.

4) Dopamine is not an "addiction" chemical. Dopamine is a neurohormone signifying an energy replete condition; the physiological and psychological effects of high dopamine promote of energy waste and opportunistic behavior which is otherwise adaptive. Addiction is merely a disease that implicates dopamine, but by no means is "addiction" synonymous with higher dopamine. A high dopaminergic tone is essential for emotional well being, normal energy use and low body weight.

5) A low dopaminergic tone is an almost universal finding in all energy conservation states, in both animals and humans. The obesity specific dopamine behavior of a low basal tone + exaggerated dopamine response to food intake is in service of energy conservation; it promotes eating behavior at meals and fat retention when fasting. This is a normal function of a low dopaminergic tone. It is NOT an addiction to food. Food reward is simply a myth, either a lie or a comical misunderstanding of physiology, but a myth all the same.

6) Leptin neurons exert master control over the tone of the ANS, whether relatively PNS dominant or SNS dominant. A diminished leptin signal promotes PNS dominance and escalating body fatness. A strong leptin signal normally augments SNS tone and is highly antagonistic of obesity.

7) Most importantly, understanding the physiology of leptin with regard to weight regulation makes it abundantly clear that the adipose controls the brain, not the other way around.  Certainly many of these leptin specific effects control the brain, but the brain is merely passively responding to the condition of the adipose tissue via leptin feedback. This is a critical blow to Guyenets "brain uber alles" facile view of obesity, which allows for a mythical world where food pleasure, or "reward" is sufficient to drive obesity. Actually, it is abundantly clear the brain passively receives feedback from the energy needs of the fat tissue, and then modifies physiology accordingly. This is a huge insight into why the "insulin hypothesis" is more correct than not correct, and why low carb diets are so effective.



Okies folks! Next entry I shall speak more of the SNS specifically, and what goes wrong when people stall out, even when initially they felt fantabulous-astic on their low carb diet :D

The physiology of body fat regulation. Introduction! Ketotic Nausea, Obesity resistance, Stalls and more.

I would like to spend a few blog entries rambling about the physiology of weight regulation.

This is really foundations, but it is an essential topic to be at least casually familiar with.

Many would be dieters are quite ignorant of this subject, and/or they are misinformed by various self styled gurus (ahem, Big C). The misinformation is particularly acute pertaining to the relationship of fat regulation and post weight loss, body fat reduced states. Certain gurus have a vested interest in denying the fact that body fatness is tightly regulated and almost entirely outside of conscious control long term. This is because our society largely presupposes that obesity is a moral defect or a result of accidentally over eating calories. It goes against our moral beliefs that the obese state may be actually a relatively "normal/stable" condition, at least partially. Body fatness is not random, not accidental, not the result of over eating "rewarding" food, but actively regulated by the endocrine system and nervous system. It is not caused by "rewarding"  food. Wanting to eat more "rewarding food" is merely one fragment of a symptom of weight regulation effects. As has been pointed out many times before, stating that "food reward" causes obesity is like saying "oxygen reward" causes respiratory/cardiovascular abnormalities. Respiratory rate is reactive to the concentration of oxygen/carbon dioxide in blood. Relatedly, eating behavior is the result of a myriad of energy deprivation cues. No one eats for any other reason. Fullness and satiety, by its definition, implies lack of further responsiveness to food cues.

Understanding this innate, unconscious, automatic regulation of body fatness logically means one cannot cannot arbitrarily reduce an aesthetically unsatisfactory body fatness long term via CICO dieting, much to the chagrin of the missionaries of puritanical masochistic self starvation, namely Big C & Stephen Guyenet.

This is obviously an enormous subject so I attempt to work at it in pieces ;)

Background: 

I blogged a few weeks ago, toward end winter/early spring regarding how I was getting SEW FAT from sedentary activity and generous caloric eating that I was starting to have "ketotic nausea" again. For those unfamiliar with the concept, "ketotic nausea" is a term I made-up describing the phenomenon of fat gain resistance to the point of uncontrollable negative energy balance when following a ketogenic diet. It is experienced when the physiological ability to assimilate consumed nutrition into fat tissue is so poor that one experiences nearly maxed out nervous system and endocrine compensation in the form of nausea, very low appetite, and high energy/heat if they should consume a high energy intake.

Please bare in mind all obesity resistant people experience such compensation whenever they attempt to "over eat" food of any macronutrient breakdown; the adaptive response to hypernutrition is nausea, repulsion, food avoidance, anxiety, urge to exercise, and increased thermogenesis. On the other hand, people predisposed to obesity typically will not exhibit much innate compensation to hypernutrition; there is little rebound compensation for hypercaloric eating in obesity. If anything obesity prone individuals like myself can tell you we are apt to experience increasing hunger and fatigue. As this study suggests, the difference between thin people and obese people is not "reward sensitivity" to food at meals, but rather adipose/body fat regulation defects in the post-meal state. This is demonstrated by food seeking behavior relatively shortly after eating in obese people, whereas obesity resistant people do not demonstrate this, and naturally consume less calories in response to eating a great lot of calories at any given time.

What this implies is that obesity does not occur at tasty "rewarding" meals, it is made in between meals - body fat oxidation/regulation defects. Thin people will eat less after a large caloric intake, because the nervous system and endocrine system are antagonizing growth of the adipose tissue. Fat people will not eat less; fat tissue growth occurs, and caloric intake remains approximately the same later on. (It's interesting researchers hypothesize "cognitive training" might help reduce eating behavior; it seems they assume the fat people are eating more due to mindlessness as opposed to correctly assuming they experience more hunger. The moralizing/blaming is a default assumption, ha!)

I want to repeat this crucial point: all healthy people normally and naturally experience food avoidance, aversion, nausea and repulsion when they attempt to over eat.  They also experienced increased metabolic rate, anxiety, thermogenesis and a pressure to move and exercise in addition to the appetite changes. This is not some magical property of the ketogenic diet; all a ketogenic diet does is transform any individual into a relatively more obesity resistant one by raising the resistance to obesity threshhold. The ketogenic diet is a therapy specifically for obesity (amongst other conditions). Whatever your baseline level of obesity resistance, the ketogenic diet typically increases it (sometimes quite substantially, as in my case and many others).  Obese people find it anomalous and remarkable when we experience this change on a high fat low carb diet because the difference can be quite stark, for most of our lives we have responded to nutrition with lethargy and hunger. Thin people, however, have been experiencing this their entire lives,  and they experience it whether they over eat cake or over eat bacon. (Sam Feltham's experiment certainly was entertaining, but my money is on this man not being able to gain much weight even if he did it on doritos. Well, maybe he'd be fatter on doritos and feel worse too, but I doubt he could ever gain much body fat even if he tried. )

I digress. What I attempt is to isolate this phenomenon - obesity resistance vs proneness - as being a total body phenomenon (as some isolated aspect of "brain" or "appetite").  What is the difference between extreme responsiveness to food cues, low satiety, high appetite, lethargy that characterizes obesity and associated intuitively with  "a high carb" diet,  vs "ketotic nausea" and implicit obesity resistance as I describe above? 

Food reward doesn't help. Attributing obesity resistance to low responsiveness to food reward is like attributing my cardiovascular health and normal respiratory rate of 10-20 and HR of 70 to "low oxygen reward". You are taking the results of a system and assigning hierarchical importance to it.  Food is "rewarding" when ones nervous system and endocrine system is primed to grow adipose. All normal people experience food reward when they are hungry, but then it terminates once the nervous and endocrine system responds appropriately to fed condition. What is occurring in obesity is increased food responsiveness as a RESULT of obesity proneness; it is one of a myriad of effects that differentiates the obese from the lean, mind you.

The ketogenic diet increases obesity resistance, certainly, but it typically cannot adequately or entirely control obesity. Individuals such as myself are outliers and I am quite aware this is the case; my story is remarkable because of the degree of efficacy ketogenic diet exhibits in my own obesity. However, partial response is common, and a few respond virtually entirely as I have. I also hope to explain the "long term stall // pressure to regain" phenomenon that plagues so many dieters including myself. The stall is merely one facet of unconscious body fat regulation.  Previously I described that ketogenic diets work by altering physiology to increase obesity resistance; weight loss exerts an opposite pressure, increasing body fat gain proneness. The stall occurs when the weight gain resisting properties of ketogenic diet are cancelled out by the weight gain encouraging effects of body fat atrophy. As one gradually reduces body fat stores secondary to long term VLCarb diet the ability for ketogenic diets to further "work" to reduce body fat eventually slows and diminishes. The "ketotic nausea" which was a 24/7 proposition at 350 pounds, isn't so much at 150 pounds, basically.

As an aside, Carbsane with her shitty reasoning so typical of her would tell her naive readers ketogenic diets "poop out" and we "stall" simply because they don't work. This is a gross distortion to point of lie. Saying ketogenic/low carb diets don't work because all people typically "stall out" is like saying the diuretic furosemide doesn't work because people still have incomplete remission of the underlying illness while taking the diuretic.

 "Well, if furosemide worked, my heart failure would be cured!" <Prior to furosemide your O2sa was 87% and your RR was 35 and your B/P was 95/65 and your pulse was 120 and you were coughing up blood and swollen like a balloon. 
Introducing the therapy of furosemide helped normalize your cardiovascular system and vital signs is pretty convincing evidence it does work, actually. No one ever attempted to say it would CURE you completely. Heart failure patients do not get IV lasix and turn into someone totally disease free like myself; o2sat 98% on room air, pulse 70, B/P totally normal, zero edema.  The lasix just prevents heart failure patients from dying and allows them to breathe and dramatically improves quality of life. It works very effectively but obviously doesn't "cure" anything. A person with heart failure always has heart failure and all liabilities entailed within; furosemide therapy merely radically improves outcomes.

Ketogenic diets operate similarly in metabolic disorder and obesity.

It is grossly misleading for carbsane or anyone else to say low carb diets "don't work" because you only got down to 180lbs from a starting weight of 300lbs, but your goal is 120 lbs. It's nice that your random made up goal is 120 lbs like a 21 year old movie star, but the fact the diet allowed you to shed 160 lbs effortlessly / without self starvation ought to be evidence of its extreme efficacy in treating obesity, don't you think?  Your average dieter / obnoxious self styled Carbsanian internet guru is highly medically untrained and ignorant, and generally unfamiliar with medical protocols. Medicine isn't borderline personality disorder reasoning; it's not a pivot between total success and total failure. Any medical therapy attempts to improve outcomes for ill patients and quality of life; it is always an analysis of risk:benefits. There is no such thing as TOTAL CURE or TOTAL FAILURE in medicine, with rare exceptions. Obesity is one of the only conditions I can think of where people expect *total remission* or else the therapy is deemed failure/ineffective.



TL;DR:

1) Body weight is tightly regulated and entirely outside of conscious control over a long term continuum of time.
2) Obese people exhibit poor compensation for hypercaloric feeding. Obesity resistant people unconsciously reduce caloric intake after hypercaloric feeding, secondary to decreased interest in food.
3) Attributing obesity to increased "food reward responsiveness" is confusing symptomatic effect with pathophysiological cause. Increased interest in feeding is one of many difference between the obese and lean; it is highly biased and false to focus on it to the exclusion of all other effects.
4) Ketogenic diets appear to increase "obesity resistance"; whatever baseline condition of adiposity, adopting a ketogenic diet tends to promote greater leanness for that person. The effect may be very pronounced for some individuals with pathological obesity (such as myself).
5) Weight reduction and body fat atrophy exerts an oppositional pressure, increasing weight gain proneness, eventually cancelling out the obesity resistance augmenting effects of ketogenic diets. Stalls then occur and no further weight loss is observed.
6) That ketogenic diet often exerts incomplete efficacy in the therapy of obesity does not mean it "DOESN'T WORK"; varying rate of response to therapies is par for course in medicine, and by all measures the ketogenic diet appears highly effective, safe, and generally well tolerated by most compared to alternative treatments.


Next I shall describe gross physiology of leptin and the SNS :)

A Woo Fueled Apology: I HAVE A BROKEN BRAIN.

Sorry for acting more crazy than usual a few days ago. In hindsight this appears to be an interaction of natural crazy + hormones. I shall post an illustrative graphic:

Recent days would represent the first light grey bubble. I.e. "I feel really great" and then "OMG borderline breakdown!!!" a few days later = teh estrogen rise and fall. There was also a tell tale breakout of acne, ravenous hunger, and exaggerated cortisol symptoms like GI stasis/constipation, all par for course when estrogen is too suppressed and progesterone is too dominant.

I feel better now relatively speaking because I am making estrogen again; this would be day 16 or so on the above graphic. Symptomatically, other than working brain, acne magically clears up, skin nice, appetite low, etc.

Feel pretty good :)
....FOR NOW.

Rest assured zealots, my mood correlates rather exactly with estrogen. Estrogen correlates with my appearance, in turn. Sans acne, sans hag face, happy woo. BTW, correlate here means CAUSE.

OTOH, hag face (low estrogen) or pizza face (high progesterone/testosterone) = miserable woo.
One would be inclined to attribute psychological cause to these perceptions, but I dont see how one can imagine horrific acne breakout and withered skin ?

I would also emphasize these are not effects of hormones alone, but rather an interaction of hormones and my Freakshow Fuckup Fail* brain. Things were bad for woo! I didnt paint my nails for like a week, oh my god. I have rectified this situation by applying this to my talons today:
This is a spring color but it is raining like a MOFO and I am pretending it is spring. Plus I missed spring cuz you know, moving all the times.

*TM Cow.

Random accessed / recalled memories and mood.

Like sleep, it's on the tip of my tongue, just out of reach. Moments before I fall asleep I often experience this condition of being very close to some kind of insight. I will also experience an endorphin-like tactile sensation that is pleasant. It comes from within my brain, almost like a seizure; I feel it in my hands, it affects my face and tongue; it feels like rolling my tongue, and it is like a very pleasant comforting tactile sensation. It occurs without any stimulation at all; the brain process of going to sleep seems to create some kind of illusion of a pleasant tactile stimulation. It reminds me of infancy and being nurtured by mother, a memory I likely confabulated.


I can't experience it while fully awake but if my brain begins to drift to sleep, it can happen. When I am half awake I try to perceive analyze and understand it, but I either fall fully asleep or become fully awake and loose it instantly. I believe if I can understand this, great insight lies there. How can you understand a condition you only feel in fragments and lose as soon as you slip on either side of consciousness? I can't even look it up on the internet as it is not well defined enough to even write down.

"Fuzzy tactile stimulation endorphin like face hands tongue false memory of infancy" <<< NO HITS.
Imagine that.


I wrote this in my previous "WTF is wrong with you" entry, but I've noticed for years now, that when my mood is low, I randomly relive memories. I do NOT DO THIS when my emotional state is more appropriate. I will have flashbacks to very benign random memories from some other time in my life... and the experience comes to me in full color; aura, sight, smell, sound; I temporarily relive. This is considered specific for a biological low mood; when I start having neurological malfunctioning and randomly accessing memories while awake.

 I tend to think it represents sleep-like brain processes operating during wakefulness, secondary to lower serotonin and higher melatonin.

More evidence of this is the fact that when I sleep, and sleep long, I will typically remember dreams and wake up during dreams. Dreaming more is very specific for lower mood and again I think it represents alterations in brain metabolism, blood flow, secondary to alterations in serotonin and melatonin, with a bias of relatively more melatonin dominant. Evidence suggests giving normal people melatonin can depress the mood and disrupt sleep promoting dreams and nightmares.


Memory formation is related to sleep, and I believe the "random memory access" is related to all of this; as if the areas of my brain pertaining to memories are somehow hyperactive via this melatonin bias and relative serotonin inhibition.

Emotional lability, irrational anxiety, low mood/motivation, hunger for food, avoidance of stress/ordinary responsibilities and pain sensitivity would just mostly be symptoms of relative serotonin insufficiency (and by logical extension endorphin insufficiency).
 

These things must be understood, they are very important.

My non-existent god, JudgyBitch is a complete and total hateful moron.

Due to the total lack of lulz in the paleosphere, i have been traipsing about like a junksick addict over on the manosphere side of the paleo pool. This slumming behavior landed me squarely at judgybitch.com.

There is so much to hate at judgybitch.com. SOOOO much to hate and mock, really, but this article just stood out at me and required immediate mockery:

Disney Princesses are kind and pretty and that’s bad. Disney Villainesses are evil and cruel and that’s awesome! Disney Princes don’t count for anything at all. Feminist Disney theory is hard!

 Where do I even begin?


I would say what really incited me to blog, was the repulsive description of jezebel writers "fantasizing" about having sex with an underage cartoon character.

I'm not a feminist really, and I don't follow Jezebel, but I seriously doubt Jezebel could be this deranged even when wildly exaggerating. I read the article she linked to, and it was nothing of the sort, in fact it was merely a summary of a mainstream magazine article written by a MAN. The article, which was written by a man, was as uncontroversial as sating this particular disney cartoon character might be gay because her behavior is not hypergender conforming. OMG!!!DISNEY MADE A PRINCESS MOVIE ABOUT A TOM BOY, HOLY FUCK THOSE PEDOPHILES. There was absolutely no talk of the "appearance" of the cartoon as being underage and absolutely nothing even remotely like sexual fantasizing. Summary: JudgyBitch is a grotesque loon and also a homophobe apparently.

WTF bitch, are you demented and also sick in the head?

Hey, I wonder if JudgyBitch thinks gay people (women) are enemies of the sacred holy matrimony working to sabotage happy heterosexual couples? Like, all those ugly fat lesbians are recruiting naive women to join their man hating army? Life was perfect with women staying at home raising children, happy as can be, and along come these angry lesbians and feminists, and now NO ONE IS HAPPY!!!!1111 WOMAN SEW HAPPY IN DOMESTIC GODDESS ROLE UNTIL UNSHAVEN FEMINIST CAME 2 TOWN OH NOES. *roll eyes* 
Yes, this is exactly what life was like for women before feminism. Happy ladies making cakes raising children with loving protective men who respected them. 
Fucking dykes ruining everything!!!

Next on the LOL docket, JudgyBitch describes a 16 year old girl "on the cusp of womanhood" when actually, sorry to break it to you JB, 16 year old female is PEAK BEAUTY from a male standpoint. No one wants your dried up 40 year old ass, not your loving gentle manosphere pals. Perhaps this is why you are so "judgy" and hate "slutty teens" so much as well, and go to great lengths to shame young girls for being victims of sexual assault? BITCH YOU MADE MEN ATTACK YOU precocious ass whore!!!

Next she attempts to argue disney villianesses are just as beautiful as the princesses, the only difference is they are mean. Patent bullshit. The villianesses are always portrayed as an aging 35+ miserable woman, EXACTLY LIKE YOU JUDGYBITCH. The disney princess is always a nubile 16 year old and the villianesse is a 35+ yr old sun setting matriarch who is extremely jealous and hateful and tries to destroy her for youth and beauty.  This is the same old disney princess story over, and over again (and a reflection of many conserved folk traditions BTW).

In fact, the judgybitch.com website could basically be a disney cartoon. Jealous envious bitter 35+ year old crone sits on computer, high fiving rapists and brutes and other jealous 40 year old women (ladysadie), while shaming publicly 16 year old girls who were abused/violated/victimized. Judgybitch, you are an IRL disney villianesse! I will call you Queen Cuntessa from now on. All the teenage girls you attack, are the princesses. Your slobbering manosphere pals are your evil buffoonery henchmen.


I would also take a moment to point out disney villianesses being portrayed as thin was a phenomenon in the decades before the obesity epidemic. Cruella DeVille and the evil aging sleeping beauty stepmom are all frigid wasp size 0, but they distinctly lack feminine beauty and have the body shape of an aging estrogen deficient woman who is dried up and spent. Fat women/people in disney cartoons were mostly used for comedic effect. Post obesity epidemic, the evil jealous matriarch began to look more like ursula the sea witch - morbidly obese.  

Disney villianesses are traditionally portrayed as emaciated thin insecure aging neurotic women is because generally speaking it is a real life phenomenon that step moms abuse and are jealous of their teenage daughters. Even biological moms, sometimes. There are tons and tons of folk tales describing this well known not at all a secret phenomenon. As stated many times and over and over, just as men sexually exploit teenage girls for reproductive reasons, older 35 year old women attack, reject, and shame teenage girls due to competitive threat and insecurity. Just like you, JB. We really are all animals at the end of the day, it's all in service of reproduction. It's okay, I don't blame you.

The disney villianesses are visually depicted as bone thin, because narcissistic hollow women who were once beautiful and prominent in youth, desperately cling to past, and still rigidly maintain their low body fat levels even in their 40s 50s and 60s. In fact they are inclined to more aggressively starve themselves and lose more weight as they age. We all intuitively know this as human beings, we've seen examples over and over, and the cartoons are merely reflecting life. How many of us know that status seeking washed up 40, 45 year old woman aware of her lost youth/beauty, who starts dieting and exercising hard core to regain her youth, only to end up looking like a shriveled crone with zero estrogen? How many celebrities have we observed do this? (Demi Moore, Angie Jo, etc). The caricatures of Cruella DeVille and Evil Stepmother are just representing this phenomenon.

Furthermore, extreme thinness is often associated with a neurotic high strung disposition, and again this is intuitive knowledge all humans are aware of. The HPA axis and high catecholamines (creating nervous/high strung behavior) also promotes food avoidance and constant body fat metabolism and activity, and emotional malcontent. Meanwhile, "fat" disney characters (at least pre 90s obesity corn sugar epidemic) are portrayed as laid back and happy and not too high strung, although perhaps oafish and buffoon like as well (and again, thinness = associated with high strung neuroticism and excessive future oriented thought processes , therefore more likely to be associated with intelligence relative to a trait like impulsivity and lack of concern for future, more likely to be associated with low intelligence. Evil villains are ALWAYS ruminating and scheming of future plans, and they are always intelligent, and they are always bone thin. Art reflects life and there are well established neuroendocrine explanations for these stereotypical observations.)

So basically she rambles on, making a final point that being beautiful and disney princess like and landing a husband is all that matters for female happiness and this is true, and EVIL FEMINIZST is wrong to encourage girls to learn skills , try to be effective independently, and think of themselves as human beings vs chattel to be bought/sold/evaluated.

I would disagree that marriage makes women happy; being happy makes people happy. Marriage is probably more accurately described as a marker for being well adjusted and happy. The cartoons , like religions, like secular folk tales, exist to enforce values which preserve and strengthen society. For example, in modern times we see disney cartoons reflecting government political indoctrination of multuralism and egalitarianism, which are artificial modern values crucial to maintaining our social structure. A few decades ago disney cartoons were all euro, all christian, and promoted dogmatic family values, because at the time those values were prosocial (eurocentric and patriarchal and christian).  It is not a coincidence the earliest disney cartoons were reproductions of old european folk tales / childrens stories, as well.

Now we have more politically correct multicultural stories like "aladin" (middle eastern princess) "mulan"
(asian princess) and "princess and the frog" (black princess) and "meridia" (the not gay, gay princess) which enforce our artificial multicultural modern society (BTW, I think it's fantastic). The stories don't guide people toward happiness and they really arent intended to; they advertise & enforce pro-social behavior would be a much more accurate description. This is true of all folk tales.

It is a joke to say marriage and child rearing causes female happiness; hilarious hilarious joke. Marriage doesn't make women happy, and no one gives a shit about your happiness anyway might I add. This is the real world, JB; you aren't entitled to happiness and guess what your genes don't give a shit if you are happy, just as long as you shit out a few kids that can go on to shit out a few kids, that's really all that matters in the grand scheme great big cold hard truth of things.

Female happiness - and guess what - really doesn't matter. Happiness is the reward for successful competition, and females don't compete. Females are the reward. Deal with it.

There is a reason depression rates are so high among women and it's not because of a lack of  the guiding patriarchal hand of a strong male leader, you moron. It's because females are naturally anhedonic relative to men because FEMALE HAPPINESS NEVER MATTERED for success of human species, and guess what, it still doesn't matter. You are a birthing machine for the most successful men in a great elephant seal competition called life. These stories, like religious fairy tales, like folk tales exist first to entertain and secondarily to strengthen SOCIETY, of which you are a tiny little ant peon cog in a wheel. You aren't entitled to happiness JB, and if you are genuinely happy (rather than faking it like most others certainly), good for you. Consider yourself in the minority particularly amongst women; women, as stated, who are naturally anhedonic and miserable relative to men, simply because impulsivity/hedonism are actually antagonistic of successful female reproduction (and just not at all important for making a maximum fit, healthy, gene reproducing machine; in fact, a heaping dose of masochism is most reproductively beneficial for a female. Hence the female brain specific disorder of anorexia nervosa and various other masochistic female behaviors. On the other hand, "extreme male brain" results in psychopathic, which would be described as wanton reckless hedonism to the point of sadism.)

You're welcome.


Signed,
The most miserable of all the miserables in the les miserables paleo play.

It is a simple fact everything is awful.

On my 4th day of poor sleep (hahahaha LOL I R SLEEPING WELL GUYZ ! ) I was sitting in my car, reflecting upon the world , and I came to the realization that life is awful. I don't mean this in some kind of "I have a mental illness and cant perceive pleasure" sort of way, I mean it in a "I am totally unadulterated and its just a frank fact the world is shit" kind of way.

Happiness and joy are the real delusions; like carrot before horse, happiness is a delusion prodding us to keep slaving on for no ultimate reason, conning us into thinking there actually is a point. Dispassionate apathy and a cool reasoned acceptance that life is shit is the default human condition, the sane perspective.

I would say the worst thing about life is true human nature. Humans are animals of the worst kind. More than anything else, the depressing understanding and realization of human behavior is most disheartening.

Saw this on Tess' facebook and i was like...this is real life. Just a small example of real life, mind you, but this is human nature, this is what "free unpoliced humans" will do... crowd children into a factory or a coal mine and work them to literal physical DEATH. Want no government, want no fucking laws? Look above at that picture, asshole. Stupid, stupid fucking libertarian/anarchist/morons.

The truly depressing thing about the world is not how it actually is, but the fact that like a captive in a cage there can be no other way; the best we can do is create this matrix like grand illusion lie modern society and central government that goes to great LENGTHS to apologize for and cover up true human nature. We have all sorts of elaborate laws and systems in place to equalize people, or to simply deny all together any inequality naturally exists. I think the funniest part of it all is the fact you have ugly stupid people who would wish to overthrow it and revert to human nature at default.

But brutality is true to us. This is in our genes, this is what we are. Like elephant seals fighting to death over a harem beach, we are brutal and ugly. Humans are vile repugnant creatures.  Again, look above. That's what happens when there are no laws and people do what is in their immediate prosperity and gain. They get a bunch of poor kids with no parents and no one to protect them and work them to death in a mine. THIS is what people do, without laws and government. Not your kids, who cares right? Oh well, it's the way of the world, I guess. Or, perhaps, magically, this won't happen in your libertarian government-less utopia. Somehow, in your libertarian utopia, people will independently create safety nets for all these street urchins so a capitalist monster won't end up enslaving them. Somehow, the magic of the free market will work.

WE TRIED IT ALREADY. IT DIDNT WORK. We tried zero labor laws and total freedom for business. Look above, you stupid myopic asshole. We know how this ends up, YOUR SHIT WAS TESTED ALREADY AND FAILED like a mexican child on WIC food rasher taking a standardized test.
What's that? You're not a child, you don't have a child, or alternatively you protect your child like a badass should, so yea I know who gives a fuck. Not you, that's for sure, and I guess it will work out somehow by the power of the free people sans government oppression. LOL.


The worst part isn't how it is, or how it was, but that its all that can ever be...and we go to great lengths to lie to ourselves, distract ourselves, create elaborate governments and systems to hide our true selves.

Vampire science fiction movies are very popular. People are fascinated by vampire movies because deep down all humans know we are vulgar animals and predators, fighting our true nature. The science fiction iconic monster known as a vampire is basically a creature who pretends to be human but is only sustained via predatory blood drinking behavior, constantly fighting their murderous nature. Unlike a psychopath who is motivated by frivolous pleasure and self gratification, the vampire kills because it has to sustain itself, it is nature and life.  Some vampires like to kill and some hate to kill but all have to kill because it is who and what they are.  Whether we have insight or not to understand this, human beings are all very acutely aware of our true natures; the reason fictional vampires are fascinating is because they embrace and acknowledge their horrific nature due to lack of choice.

I am no better, I am a selfish hollow person, a liar, a fake, etc. What makes me even slightly different is a slightly marginally increased insight and awareness, and a bit less delusional brain chemical induced happiness relative to your typical person (the former likely a product of the latter, BTW. When I'm happy I'm too busy dancing to music and enjoying the weather vs thinking about how life is complete meaningless shit).

Thursday into Friday woo fueled mope session.

Edit: for extra inflammatory effect, I would like to add one more comment.
I spent my whole youth feeling depressed and inadequate over the fact I was a morbidly obese monster with severe endocrine disorders throughout my teens, and many years after that lamenting the damage to my body and my life from this experience. Now that I am 30 and much more wise, I realize this is actually a blessing in disguise, as all evidence suggests most non-obese attractive teenagers are victims of rape and sexual exploitation by male relatives and family friends.   Of course, it wasn't until recently I became aware of this, the widespread sexual abuse and exploitation of women as a default function of human (male) behavior. Most people think it's something that is very rare, very isolated. Newp, it happens to most young women actually, except perhaps morbidly obese shut ins. I'm actually *grateful* at this point in my life for my history. I don't need PTSD/ hypervigilance on top of all my other fuck ups.


I R is a bummer, though, so don't be surprised :D