Diet, Metabolism, and Body Composition

History of everything that hasn't worked for me, and some stuff that recently has

Diet, Metabolism, and Body Composition

As anyone who knows me personally - currently 100% of the readership - knows that I’ve always been somewhere between a bit and a lot overweight. In the last 6 or so months, I’ve tried to investigate why all the diets I’ve tried throughout my life - and there have been many attempts - have failed to create lasting change.

In the last few years there has been social discussion around destigmatizing body-sizes and focusing instead on health, and it’s metabolic markers. This has largely been a good thing. Accepting a wider range of body shapes and sizes as healthy, and not deifying bodies that are ideally thin or have the right amount of visible musculature. Some of this is down to genetics. Some of this is from performance enhancement that most people would do well to avoid, but is nevertheless visually represented.

For decades, we have heard the medical and public health chorus singing the song of moral responsibility of the individual in maintaining healthy weight through control of diet. Though the verse may change based on the fashion of the decade - first if it was saturated fats we were admonished to go without, then cholesterol, then carbs, etc. etc. - one constant has been the perception of a moral failure on the part of people who were or are overweight. As a good friend of mine once put it “being fat is the only vice that people can look at you and immediately make a judgment about you, and to know that you struggle with self-control”. That’s not the whole story.

I’ll spare you the suspense. It's probably 80% Ultra Processed Foods (UPF), and 20% eating behavior, or what some call Intuitive Eating or Mindful Eating.

One note: While I hold degrees in Chemistry and Biochemistry, I’m not a medical professional. These are my opinions based on limited sources in a highly contentious field, in which I am a layperson. I encourage you to look at these as such, make your own judgments, and always consult with doctors when it comes to your health. Not all health advice is appropriate for all people, and this certainly is not medical advice, and is offered for intellectual and entertainment value.

Early life - or what hasn’t worked

When I was a child, I was by all accounts, metabolically healthy- if hyperactive. As I got older the hyperactivity seemed to be an issue in schools. There were many schools because of said behavioral issues. Doctors began treatment around 7 or 8 years old. In treating hyperactivity, side effects of certain medications emerged which were treated with still other medication. These slowed me down and changed my appetite, and I began to gain some weight. Treatment for behavioral issues was stopped.

There’s a picture, somewhere, of me at the Grand Canyon, around this age, shirtless, Dr. Pepper in hand, with a small paunch. I became chubby, but by no means extraordinarily chubby for an American child. And besides my continued hyperactivity and home-schooling, I was a pretty normal kid from age 8-10.

When I was 11 my mom got married. With my step father, came a massive change in our household diet. Sodas, chips, juices. Now there was no shortage of options. Ultra Processed Food became the primary source of food. My weight exploded during my preteen and early teenage years. I don't have exact figures, but visually estimating I would put it easily in the 40 - 45 BMI range. I remember my doctor at the time categorized me as morbidly obese, 95th percentile for my age. Wagyu child. My waistline steadily increased in size through my teenage years. I had a series of joint issues that were never formally diagnosed, but I believe it may have been gout or maybe arthritis, because sometimes it would hurt ankles so much to put any weight on them, that they would buckle in pain. Only a few such episodes, where pain lasted days.

CICO

It was around this time, at the age of 13 or 14 that I tried my first diet. First Calorie Restriction at the behest of my doctor, which with no real structure or support to the plan, did not work. It wasn’t my first or last time trying calorie restriction as a way to lose weight. What I didn’t know then, but I know now, is that calorie restriction isn’t strictly wrong per se, humans after all must obey the law of conservation of mass and energy, just like everything else in the universe, but the calorie-in-calorie-out model, or CICO as is it sometime called, misses two very important points about healthy diet, that I have learned very recently: the role of Ultra Processed Foods and Intutive Eating.

Keto

Shortly after my failed attempt at CICO around age 14, I tried Keto for the first, but not last time. Celery, peanut butter, diet fruit juice, and bacon was all I ate for a few weeks. I couldn’t so much as look at bacon for about 5 years after that. Fortunately I have made a full recovery.

Intuitive Eating

First, the idea that you can accurately count calories throughout your life is rubbish. Unless you take your meals at home, and weigh every ingredient, you will very likely systematically underestimate calories and food composition. This is because restaurant portions (inflated), and so our intuition about what constitutes a serving is miscalibrated. Our ability to control portions is linked to our perception of our appetite. This is the key insight, which was first popularized by Elyse Resch and Evelyn Tribole in their book, Intuitive Eating, in the 90s. This idea is also sometimes called mindful eating.

The thesis of the book is that people don’t pay attention to what they eat and their own internal hunger and satiety (fullness) signals. That our connection with food and our bodies has been cut in multiple ways.

First disordered eating practices around emotional regulation of eating. There is an additional complex with ADD eaters also We have a tendency sometimes to mindlessly eat, to eat out of boredom or stress, or sometimes just because we forget until we are ravenously hungry and then we eat in a primal, uncontrolled, state, as if we were starved, because we were starved temporarily. The ensuing guilt of our disordered eating leads us to try and exert more conscious control over it, which backfires. Here’s a cool video by Dr. K at HealthyGamerGG I liked on the subject.

The more we intellectualize the eating process, and try to control our appetite for what we eat, and make arbitrary rules about what we can eat, the more we create a psychological fixation on what we desire, and fall into a cycle of abstinence and loss of self control. Intuitive eating advocates that you embrace your craving, eating exactly what you desire, in a mindful state of putting attention onto your hunger before eating, the eating process during eating, and how the food makes you feel after eating. They regard even “unhealthy” food, or play-food as they call it, as fair game for eating and craving.

The strategy then goes, if you are eating with healthy behavior - i.e. not for emotional reasons, or waiting until you are so starved for carbs that a bowl of oatmeal makes you cry - that you will naturally regulate your caloric intake. According to this book, issues with (over)eating are all in your head.

But, there is an easy critique of intuitive eating which the authors allude to: If I eat intuitively, then I eat what I crave. I essentially eat what I crave now, and that is what has gotten me in this position I am in. And furthermore, what explains the steady increase in obesity throughout not only the US in the 20th century, but increasingly the rest of the world? This is part of the puzzle but it misses something crucial.

Ultra Processed Foods

The second thing I have learned, and which the plain CICO advice you will often hear misses, is about our processed food system. There is now significant randomized control trial evidence that ultra processed food directly causes us to overeat. This work comes out of Kevin Hall’s group at the NIH, who models metabolism. He started out as a metabolic modeler very much in the CICO camp- in fact he originally set out to debunk ultra processed food as a factor contributing to weight gain, and could not falsify the premise. Yay, love it when the scientific method works. The background is wonderfully covered in Chris Van Telekens books Ultra Processed People.

He also has a great 1 hour lecture you can watch that summarizes his book well which you can find here:

What Kevin Hall showed was that if you control for all macros and let people eat unlimitedly, they will on average gain a pound a week if you let them eat ultra processed food, or lose a pound a week if you have them eat unprocessed, whole food. Obviously this is with a randomly chosen American, and so presumably this weight loss wouldn’t continue forever, and we don’t have the data to say where it would stop. It's worth noting that 1 pound per week is considered a healthy weight loss rate for people who are intentionally trying to lose weight. The people in this study were not trying to do anything; they were just eating as much as they wanted until they felt full. This is the element that the pure intuitive eating argument misses: our food environment.

Kevin Hall’s group at the NIH has also studied plant based vs animal product centered unprocessed food diets devoid of processed foods i.e. ketogenic diets, and found that people eat less on plant diets, when eating to satiety, and interestingly the weight loss is more concentrated in fat tissues.

Foot note to the above:

I’m speculating here, but I’d guess this is because of glycogen and water depletion, whereas in eating a high carb plant centered diet, your glycogen reserves would be high. Furthermore, we know that a lot of the weight lost in crash dieting like in ketogenic diets, are glycogen and water weight as your body depletes 100% of the stored carbohydrates in your liver and your muscle tissue, and the associated water.

Simple rules for spotting processed foods

• Anything with added sugar

• Anything that you cannot buy without a food label

• Anything that comes in a mass produced package

• Anything that is very soft to bite into, like cakes, processed breads like white bread

It’s the fiber stupid

This idea that ultra processed food causes overeating also goes back some ways. Some people refer to it as hyper-palatability. The food is engineered by food scientists to be irresistible to your brain. By the combination of macros and salts and textures and flavors it can cause your brain to override typical satiety signals, or eat so rapidly that we overeat before we realize we are full.

This idea, specifically in regards to ultra processed and that is directly causing the epidemic of metabolic sickness throughout most of the developed world, was pioneered by Brazilian epidemiologist Carlos Monteiro. The system is called the NOVA classification system. and the definition of Ultra Processed Food is an interesting and worthwhile read.

Unfortunately the scientific literature on the topic of processed foods in our diet has been heavily polluted by corporate funded scientific research- many tracing their funding back to not-so-disinterested actors such as Coca-Cola and Pepsi corporation.

There is a conspiratorial rabbit hole here on the level of tobacco companies and lung cancer, or oil companies and global warming, and a complete failure of governance, that I won’t go into. (We really gotta do something about corporations churning out BS science as PR one of these days, because it costs society trillions of dollars, but that’s a political topic for another post).

But hyper-palatability is only part of the story. The physician Robert Lustig has been early on the impact of ultra processed food on metabolism. Essentially, processing all the fiber and water out of food, and filling them with stabilizers, and various texturizing agents to restabilize foods, does not make them great for our digestive system. In fact it makes them quite bad metabolically. We get too much sugar too fast, and in part that is because fiber, once taken out of the food, can’t actually be added back in in a way to preserve the nutrient release profile of unprocessed food.

This makes sense if you think about it on a cellular level. When you eat a piece of fruit, say a raspberry, the sugars in that fruit- fructose- are each in their own little cellular balloon, surrounded by a tough fibrous layer of cellulose. In order for those contents to be released they must be chewed, acidified, and enzymatically broken down. This process is limited by the surface area for attack.

Conversely, if you take an ultra processed food, say a preserved pastry that contains a raspberry filling, the fruit has been mechanically processed, cooked, strained, fiber removed, and mixed with other starches and fats to stabilize. Even if you add “fiber” back in, it’s not going to affect digestion speed. Processed foods are characteristically soft, because they have no subcellular structure - its all cake, essentially, just extruded and cooked and seasoned differently - and so when you eat it, the material hit your stomach and completely disintegrates, and is very quickly and easily absorbed by your body in the intestines. Moreover, those added texturizing and stabalizing agents are now thought to disturb your gut microbiome.

Lustig’s mantra is to protect the liver and feed the gut (i.e. the human microbiome), and both of those things are accomplished through eating whole foods containing fiber. Critically it must be fiber from a natural food source, not a reconstituted fiber, such as a supplement, or additive. Many studies have also demonstrated the link between fiber consumption and all cause mortality, possibly due to improved gut health in general.

It turns out also that our microbiome needs unprocessed food fiber, the combination of soluble and insoluble, packaged with nutrients, for optimal support. This creates a fibrous gel in the colon that is the ideal colony for microbes. Some processed foods and supplements will advertise the presence of cultures like lactobacillus added or other gut microbes. The truth is that these microbes exist everywhere - like starter yeast in the air - you don't need supplements to inoculate yourself with them since they are on the foods we already eat. It doesn't hurt to eat yogurt but you don't need supplements for them either. But if your gut does not have the right prebiotic fiber composition, it will not matter what probiotics you ingest. You can only get this fiber composition by eating whole plants.

This not only affects the microbes that live in our gut and balance our gut health (and research would suggest also our general happiness and motivation), but it also causes massive amounts of nutrients to hit our blood stream all at once, which can affect our hormones related to fat storage and energy metabolism in undesirable ways

Lustig is generally against processed foods, especially added sugar foods. He argues -persuasively- that carbs, in excess, are more dangerous for your liver and heart health, than even high fat in an energetically appropriate diet, because fructose, of high fructose corn-syrup fame- are actually turned into cholesterol very rapidly when eaten to excess. And the worst kind of cholesterol: vLDLs or very low density lipoproteins. vLDLs don't have a common lab test, and so we don't screen for them, but they are known to be more plaque forming that normal LDLs. This at least in part explains why diets high in ultra processed foods, in particular simple sugars, are so negatively correlated not only with regulation of glucose and insulin, but also associated with arteriosclerosis- because excess fructose is converted into vLDLs directly.

20’s - Coffee, cigarettes, & powerlifting

In my latter teen years, a diet of cigarettes and coffee continued to slim me down, but still clinically obese. Hiking continued with added simple body weight exercises, and moderate weight lifting, no more than 50 lb dumbbells, on no particular program, and hitting a punching bag, as primary physical activity. Visual estimate of BMI: 30 In my early 20s,

I read the book The Four Hours Body by Tim Ferris and took ownership of my diet, and food preparation. This book recommended something called the Slow Carb Diet, which was somewhat effective, owing largely to the fact that it happened to eliminate most processed foods, by eliminating all carb sources that were not legumes. Like most fad diets, they are successful by limiting calories, but aren't practically enjoyable to sustain because they involve the intellectualization of the bodily process that is eating, and so they suffer the same psychological pitfalls of denial and capacitation of desire until that desire must be discharged. The Slow Carb Diet was an improvement on normal diets because they allow for a cheat day once a week, and removed most processed foods, which makes them sustainable much longer, but even the concept of a cheat day reinforces the idea of a cycle of abstention and binging.

Additionally, around this time, for 6 of the healthiest months of my life, I added powerliftings, coached to routine once per week, with compound lifts taken to failure. I was cleaning and I was jerking- and I promise that is the terminology. I started running mostly on hiking trails on the flat parts. Runs through redwood forest on a cold day and felt alive, flighty, felt like a dream, bounding over crackling sticks and down ravine on the soft loamy needle bed under the cool damp green canopy of the giant redwood trees of Joaquin Miller Park.

I achieve the lowest visual body fat of adult life, never crosses below the 200lb mark on my 6 foot frame- never not clinically obese. Visual estimate of BMI: 25-30. And then I stopped powerlifting because I ran out of money which was sad.

My muscle tone deteriorates significantly as a result diet continues, primarily legumes as carb source. Weight is maintained through this time. Primary exercise is walking as transportation, some unstructured weight lifting activity, bread and alcohol are part of diet, but avoids most sugar, and sugar sweetened beverages. There is some fluctuation but remains roughly steady hovering around a BMI of 25-35.

When I graduated college in my mid 20s, the change in lifestyle coming with an office job did not do me any favors. I start boxing classes to try and get some physical activity back in. However diet deteriorates, carb sources are expended, sugar is reintroduced, admonished by healthcare providers to please lose some weight. Still metabolically healthy. Try Atkins again. Relapse again after a couple of months. Back to graduate school weight maintenance, lots of walking about campus, mid to low 200s, no real dietary controls, avoiding sugar beverages, except in the form of cocktails, and maintaining some routine of weight lifting under the Texas 5x5 program.

Drifting upward

Leave graduate school, primary transportation driving, completely sedentary work environment. Now I can afford to eat out whenever I want, and especially “on the go” - so lots of fast food - prohibition on soda is removed. Cocktail consumption is almost daily during some periods. This profoundly changes the energetics of my body. Often feel stressed or sad or bored and eat to deal with that. Over the course of a couple years, weight creeps up on average a half pound a week. My gym routine is non-existent. Losing muscle tone.

Every 4-6 months in this period I get concerned, start tracking my food intake, and start going to the gym. Never lasts more than a couple months. Have a couple of over training injuries, from trying to start too fast. Only dietary control is calorie counting, but I am eating absolute garbage, fast food, all the time, but I’m logging everything. Baffled by my food logs, and all the online calculators and apps say I should be shedding weight like crazy, but the best I can ever do while monitoring it is maintain weight, and slightly shrink waist - which is not nothing - but no weight loss. Then I would get discouraged or forget about it and the weight would resume it’s steady upward trend. When’s it going to stop? Nobody knows!

Change and the last 6 months

Around 6 months ago I had a milestone birthday, I hit an all-time maximum on waist and weight. I think to myself frequently, at this time, I won’t live much longer like this. There’s a deep sense of shame that I haven’t ever been able to get a handle on this. I have a series of mysterious generalized symptoms, extreme gut pain, fatigue, anxiety, panic attacks, and some negative trends in lab results. I feel defeated, hate food, wish frequently that I could not eat and not have to feel hunger. I consider asking for medically supervised starvation to fix the issues. It can’t be that hard after all lots of people have done it. And I should be able to understand this. Right?

Something needs to change. I make a commitment to fix this once and for all. I start reading and I start making changes.

I’ve been living by some simple guidelines.

• I avoid processed food when possible, which naturally means eating more fiber. In practice this means mostly avoiding eating foods that come with a nutrition label i.e. whole foods.

• I now think of UPF like I think of a cigarette or alcohol. Probably won’t kill me to have once in a while, but also definitely not a great long term habit.

• I try to practice intuitive eating

• Drinking water it's important. Don’t drink calories as a general rule. Don’t drink alcohol most days. (I still drink cappuccinos and have a biscotti every day). Homemade smoothies are probably okay. Little to No juice, use the whole fruit if at all possible.

• Exercise at least a few times a week, and at least once a week weight training

• Using GLP1s

Since making this commitment over the last 6-months, I have

• Re-establishes at least a low intensity cardio routine.

• Establishes some benchmarks and goals around strength conditioning.

• Sought counseling for binge eating, dealing with emotion in other ways

• Lost 5% of body mass over about 3-4 months, before starting GLP1s

• Started GLP1 as an insurance policy for about another 5% while doing that over a 2 month period. (I was stressed about the holidays and possibly overeating and losing momentum) So there is a doubling in rate of weight loss clearly.

• Weightlifting between 3-6 hours a week in total, with mild cardio interspersed, sometimes pushing cardio to the 80-90% Heart rate max limit.

• Physical conditioning is improving, indicated by walking/running pace and HR sustained.

• Strength increasing as measured by improving weekly volume across a variety of weight lifts including squat, lateral pull down, bench press, Romanian deadlift, etc. current as of January 2025. Some core lifts have improved over 50% in a few months.

• Total loss, over 10% body mass so far.

GLP1s

GLP1s are interesting. GLP1 stands for glucagon-like peptide-1 agonist. They bind to GLP1 receptors in your body and do a few different things. They trigger the release of insulin, lowering blood sugar, block the release of glucagon, which would raise blood sugar, so in absence lowers blood sugar, slow digestion, which makes you physically full longer, and also directly stimulating receptors in your brain responsible for satiety.

First they are bloody expensive. But I’ve never experienced fullness or satiety sensation and mental clarity like I did my first couple of weeks taking them. This leads me to believe I may have a long term, untreated hormonal issue, such as hyperinsulinemia, or perhaps genetically predisposed to feeling greater hunger than others, or just become wired for cycles of binging. It’s difficult to say. While I can’t inhabit the qualia of other peoples hunger, experiencing my natural state in contrast to a satiated one caused by GLP1s has such a high contrast that I would say the sensation of satiety was foreign to me before trying them. Maybe transiently for a period of time measured in minutes, but the habit of eating regularly enough to sustain this feeling naturally has so far eluded me. Perhaps it’s also the stabilization of blood sugar, one of the other effects.

The GLP1s were not without side effects. Some bouts of what felt like low blood sugar, occasionally low on energy. Some digestive issues but nothing crazy. During one period where there was a mixup with prescription, I go off of the GLP1s for about a week. Extreme hunger returns. The difference is so stark between feeling hungry on them which is like “yeah I could eat something small” to waking up ready to eat everything in the kitchen.

Overall my experience with GLP1s has been good. I view it as an insurance policy for now to make sure the momentum continues. Ultimately I need to transition off of them, and find the balance of play-food and unprocessed whole foods that works for my energy expenditure. It’s difficult to see where that is right now because it's frankly hard to eat a lot, while I’m on them. It would in some ways be nice to be able to eat more, on days when I am doing an intense workout. I feel the recovery is a little hampered by my lack of appetite while taking them.

Note about muscles, sleep, and stress

Muscles are a metabolic organ. They store glycogen (sugar), and they respond to strenuous use by proliferating mitochondria which themselves contribute directly to metabolic health. In combination, muscle mass lets your body more easily regulate blood sugar levels. Muscles are a major determinant of both length and quality of life. But this post is not about muscles, how they work, or how to develop them, so I will leave it at this: you cannot approach optimal metabolic health without a strength training routine of some sort, and some amount of cardio.

Sleep is extremely important. Not only for athletic performance, where there have been numerous studies showing that increasing sleep at the margin results in direct marginal increase in strength, speed, power, you name it. And the more active you are, the more sleep benefits you, up to in some cases 10-12 hours for highly trained athletes. For mere mortals, 7 is sufficient for health, but likely optimal for performance in 9 if you are intensely active. Why is it important to be marginally better if you are just exercising for health? It’s a tradeoff. If you can show up 10 or 15% more powerful (and these are not exaggerated gains for getting extra sleep for athletes), then those gains in training will compound over time, since you need to challenge muscle in order to grow it, it will advantage you to sleep more.

Stress is bad. There I said it now you can stop doing it. Yeah easier said than done, however stress raises cortisol and ghrelin which reduces your bodies ability to to break down fat, and greatly increases your craving for food in some people. It is possible to stress yourself into obesity. Now you have two problems. Isn’t life great?

How did this happen?

Alright I said I wasn’t going to get political but I lied a little. One must remember that the vast majority of our food is produced by corporations. They get sued by their shareholders if they try to do anything but maximize profit. This maximization of profit extends to lobbying efforts that they are fiduciarily bound to do. An iron law of optimization is that you can only maximize one variable. That is, it is impossible to optimize simultaneously for two variables unless the variables are equivalent or linearly equivalent. In plain English, corporations optimize food products for profit, therefore it’s very unlikely that they are optimized for health. They exist to make money, not provide you the best food; the end. It’s not a great way to run society's food system. Chalk one up against capitalism.

But many chronic diseases seem to be caused by processed food though it’s not exactly clear. Under the umbra of unknowns, what has proliferated is an idea that processed foods might be remediated by addition of “healthy chemicals”. Added omega fats. Added fiber. Just like vitamins right? All of this marketing fluff is to trick you into thinking that the processed-food-health issue is solved by addition. But really it’s solved by subtraction, like cigarettes, or alcohol. You just need to consume a lot less, and ideally none.

Certain vitamins have been added to foods to prevent diseases in the public. But since the FDA doesn’t look at long term impact and cumulatively toxic substances and the NIH has no authority to regulate, it has been very difficult to get food chemicals removed, or legislation passed that even nudges people away from ultra processed foods. In fact the opposite has happened. When laws have been enacted to increase the fruit and vegetable content of school lunches, for example, the response has been to reclassify fruit juices and ketchup as fruit and vegetables satisfying the requirement. And for many people who do not have the means to shop local and organic and educate themselves about all the intricacies, UPFs are the only option.

We’ve been blamed for a lack of self control in our purchasing decisions, but this is disingenuous as Ultra Processed Foods are engineered to make us overeat, and the truth has been systematically obfuscated. With no serious leadership on the issue, the status quo leads to an enormous externality for society - trillions of dollars - yet consistent profits for the industrialized food and medical care management sectors. The People pay the bill in the form of lost life, lost quality of life, lost opportunities, lost money through an exorbitantly expensive medical system, where the incentives are all wrong. It is a failure of omission in our social order and leadership, a principal point of failure, of leadership to do anything or imagine any way of fixing the problem. No taxes. No bans. No warnings. No age restriction. No marketing rules. Just silence and complicity.

I don’t want to disregard the importance of cheap food, and food chain stability. We live in a time where natural famines as a rule do not happen, and this is because of the industrial chemistry that has been developed by the processed food industry to turn any source of carbs, fat, and protein, into a shelf stable, almost infinitely flexible food ingredient. These are problems of excess, and in large part this is possible because processing makes food incredibly shelf stable. Better food would be more expensive. We should pay the price and we should pay them with nudge taxes and subsidies for unprocessed foods.

TL;DR

• Don't eat Ultra Processed Foods

  • Anything with added sugar

  • Anything that you cannot buy without a food label

  • Anything that comes in a mass produced package

  • Anything that is very soft to bite into, like cakes, processed breads like white bread

• Practice Intuitive Eating

  • Don't eat mindlessly

  • Pay attention to sensation while eating

  • Pay attention to how you feel after eating

  • When you want to eat something imagine how eating that thing is going to make you feel

• You can change, millions of people have

• GLP1s will ultimately curb appetite, but are a crutch, and won’t fix eating behavior or magically make you eat unprocessed foods

• Don't ignore stress, exercise, and sleep

Phew, you made it to the end. Drop a comment about what has worked or been challenging for you! I would love to hear your experience.

Change Echo Repeat

Dylan