On appetite
This article was linked at Althouse, and that’s how I came across it. It contains a curious narrative about what happened to one woman when she took weight loss drugs. The woman apparently lost not just weight but also her appetite for food, and stopped cooking for her family – which included adult children who got upset about her retiring from cooking the family meals.
Much of the commentary there focused on her family dynamics. But although somewhat interesting, that’s not what drew my attention. Her lose of appetite did:
It’s very hard to cook for people when you have absolutely no appetite. Every time I look in the fridge, I can’t see a single thing I want to eat. I go to the supermarket, the shops and the farmers’ market, and whereas in the past I was so inspired — buying forest mushrooms and fruit just picked from the trees — I now can’t think of a single thing I want to buy.
I’ll pick up delicious ripe apples and think, hmm … all those lovely fresh fish waiting to be grilled with lemon and butter and salt and pepper? Not one bit of me wants to eat it. I know we need to have food in the fridge but even red pepper hummus, a former favourite, leaves me feeling slightly queasy.
Then, given that I have no appetite, I don’t find cooking interesting any more. Food has become completely dull and I have begun to wonder why I’d liked it in the first place.
I don’t think this happens to everyone who takes these drugs. But for whatever numbers are affected in this way, it doesn’t sound as though it can possibly be a good thing. Oh, I understand that for those who are morbidly obese and whose lives are in danger because they do almost nothing but eat and are completely dominated by food craving, loss of appetite might come as a great good. But for those interested in more moderate weight loss – and from the photos at the article, this woman was not especially heavy before taking the drug – it seems like a nightmare to me.
I’m one of those people always trying to lose ten or fifteen pounds. But I also enjoy food, and I enjoy enjoying food. I’ve lost my appetite during a few highly stressful times in my life, and it was awful. I would stare at a plate of good food, wondering how I could muster the will to force a few bites down my gullet, and it was difficult and profoundly depressing. I wouldn’t want to lose one of the greatest pleasures in life: the desire to eat and the access to all the wonderful food we can get in this time and place. We are so fortunate to have so much abundance.
I don’t believe we should wage war on natural appetites. Yes, moderation can be difficult, but appetites contribute in no small measure to the energy that gives us pleasure and makes life worth living.
NOTE: More about weight loss drugs can be found here:
They work by mimicking the hormone glucagon-like peptide-1 (GLP-1) in slowing down stomach emptying, suppressing hunger and leaving you feeling full so that any urge to overeat is curbed. As calorie intake nosedives, so surplus pounds melt away with unprecedented speed. …
A team of US and UK researchers revealed in the Diabetes, Obesity and Metabolism journal that up to one third of weight lost on GLP-1-based drugs is not body fat but other tissue, including muscle and bone. In addition a study of obese people in the New England Journal of Medicine suggested that an average of 15 lb of lean tissue as well as 23 lb of fat were lost during a 68-week trial.
That seems alarming, as well.
I am much more ambivalent towards food. What do you want for dinner? Fish, Chicken, Beef or Shrimp? I honestly do not care. I usually opt for Nachos. Beans, chicken and cheese on a chip. Good enough for me.
My alcohol use has dropped off the edge of the world. I didn’t drink much before but now, I don’t really want anything.
It affects other aspects of your life. I’m just apathetic about almost everything. I still like to cruise but not much else.
There’s a theme park influencer in Orlando, Molly McCormack. Up until last year she was maybe 10-15lbs “overweight “. She had a very attractive face, pretty blonde, and just a little pudgy in the middle. She apparently started Mounjaro and lost maybe 30 pounds. Her face is now almost skeletal looking, and to me not nearly as attractive as before. Many of her fans have commented on the change.
Weight obessesion can be a real problem, and these drugs are not helping.
The only effect it has on me is that I feel full faster. I am losing weight steadily but very, very slowly. I have a lot to lose.
The details of weight loss and gain, metabolism, hormone releases vs. age, etc. appear to be more complicated across a population than some of the simpler studies or presumptions might fully support. We see so many marvelous medical results nowadays that we might forget that some of those advances took decades to sort out the initial issues and advance the science and technology showing such promising results.
The same will probably happen with weight loss drugs or other possible treatments. Any sojourn into a public venue shows we definitely need some help so there is plenty of market incentive to keep searching for better solutions.
It may not be a result of just the drugs.
I started one of those intermittent fasting programs recently (more properly called “eating window” program) and also find that, as my calorie intake dropped, so did my interest in food.
I have dealt with it so far by having a regular plan for eating certain types of food during my “open window,” but I don’t have any interest in cooking or looking up new recipes or trying new items.
Some of that is also from becoming lazier in my old age, not wanting to chop and sauté and fiddle with sauces etc., and some is because there aren’t 5 hungry teen-age boys to cook for. It doesn’t help that AesopSpouse went vegan a couple of years ago (medical not ethical; he did like his milk and burgers heretofore), so whatever I cook, I have to eat the left-overs by myself.
Which gets very boring very quickly.
Yes!!!!
I am very, very nervous about these new weight loss drugs. Appetite is a complicated phenomenon, and like most biological phenomena, it’s intricately interconnected with many other aspects of the body’s operations. Everything connects to everything else, in many subtle ways.
People desperately want to lose weight, and some people desperately need to do so. The motives of the first group, if we’re being honest, more often than not have less to do with being healthy than being attractive. But that too is a natural desire.
The problem, of course, is that evolution is working against us. The cold fact is that for most people, a healthy diet is less enjoyable, less tasty, less satisfying, than an unhealthy one. This can be offset to some degree by training one’s taste buds and other methods, but only to a degree, because a large part of the issue is genetic.
In the wild, the easiest kind of food to get is root vegetables and other plant matter. Fruit and high-calorie plant matter provide valuable nutrients and sugar, but take more effort to get, and sometimes more risk. Meat is especially valuable as food in the wild, but it’s even more work to get and riskier, since meat fights back.
So, if root vegetables tasted just as good as the others, humans in the wild would eat nothing but root vegetables. Easier to get and safer. So a sweet tooth and a taste for savory meat is a survival trait in the wild. It’ll motivate you to go to the extra effort and risk to get that high-value food.
Of course in a rich high-tech civilized setting, that inverts. The enjoyable food is still enjoyable, but now it’s easy to eat more of it than is good for you. You might know that, you might know that you’re better off eating more carrots and peas and broccoli and less beef and honey and fried potatoes…but that doesn’t make the carrots and peas and broccoli taste any better.
Likewise, a genetic tendency to eat more than you immediately need when you can is a survival trait in the wild. Sudden windfalls of food of whatever nature are rare, so it’s a good move to eat as much as you can when you can. Again, that flips in civilization, but knowing that doesn’t change the fact that you’re still craving food when you’ve had what your body needs.
All this has been known more or less for decades, but a lot of institutions and groups have been very reluctant to accept that it really is genetically based.
The food industry has known forever that what tastes good, to most people, can be summed up as sugar, fats, and salt. Decades ago, in the USA, the government made the food industry take a lot of the fat out of various things. The food industry knew that this would leave the food tasting more or less like cardboard, so they added sugar and salt to compensate. Nothing sinister about it, it’s just them trying to make products people will pay for.
I don’t condemn the weight loss drugs per se. Nor do I blame people desperate to lose weight for being tired of the endless, day in day out struggle against their own instincts. But the drugs are very new, and caution would seem to be called for. It’ll be years before we know much about what the long-term side effects might be or what the possible downsides are, or how different people react to them.
So, caution would seem in order.
Thalidomide seemed like a wonder drug once, too.
Regarding new, weight loss drugs, I have heard newer ones are even more specific and even newer, better ones will be coming soon and the issue neo highlights about losing muscle and bone may be less of an issue with the newer drugs.
I personally think I would avoid these because they are so new and how and why they work seem a bit risky to me, but I also think they may have a huge, positive impact on society. Carrying a lot of extra and unneeded weight causes and exacerbates a lot of health issues, especially into older ages. If an inexpensive, effective method of weight loss is found this could increase longevity for a lot of Americans and decrease medical costs.
I don’t take any medications, but I relate to a lot of what the woman Althouse highlighted states about food. Most meals I don’t really “want to eat” anything and nothing really “sounds good.” One of my least favorite things to do is going to restaurants with large social groups. I don’t like sitting at a table at holidays and feasting for an hour.
I learned when I was young that my feelings about food and eating are different from most every one else’s, and that sharing meals is an important social function others care about. I also learned that most people take a different pleasure from food than I do. The way others talk and write about food, meals, going to restaurants… I learned early to go along with this to not be anti-social, but if I were not married I imagine I would quickly devolve to eating a handful of things based on ease of preparation. I do get hungry, but 80% of the time when I am hungry and know I “need” to eat nothing sounds particularly appealing.
There are foods I like, and many of them are common; pizza, a good cheeseburger, apple pie, most fish… but if you told me I couldn’t eat any of those things for a year I wouldn’t lose any sleep over it. And if you told me that it was now illegal to go to restaurants to socialize and gatherings with friends and family had to be done in spaces where one could move about and nosh on snacks and beverages freely I would be very happy. I much prefer a party or picnic where I can mingle about, stand and move, even play some games. I was at a fourth of July picnic yesterday and did not have a single bite of food. For me, one of the least desirable ways to spend time with friends and family is seated at a table, especially in a restaurant. My wife and I have quite a few friends who are “foodies.” When they talk about a new restaurant and its menu… I act interested but I can’t, for the life of me, understand how people find food and the search for foods so enjoyable.
I have type II diabetes and started taking Mounjro long before it became fashionable. At first I became nauseous at meals then I became used to the drug, as I do most drugs, and regained an appetite. I started three, three and a half years ago. I have lost a hundred pounds. While I did lose body fat I also lost a lot of muscle mass. I’m one of those people who have always looked fat, but had a great deal of muscle. I have always been strong and took that for granted. Then sometime in the past year my strength was gone. I’m now looking into programs to regain as much strength as I can. I expect to gain weight but hopefully it will be muscle.
Surprise! Another wonderful drug turns out to have some drawbacks.
JFM, you’re one of the people for whom the drugs are especially appropriately prescribed. I hope you can find a training program to improve your strength.
Total foodie here from a family of total foodies, married to a total foodie. Normally I live my life thinking of my next 4 meals. I have friends indifferent to food, which I never understood. My cholesterol is a bit high and I do not want to take statins. Struggled for a month eating <1000 calories. Nary a lb lost. Decided to take a Glp-1 agonist. Over three weeks I have lost 8 lbs, and plan to lose 2 more and maintain for 1 month then recheck cholesterol. If it drops then I will struggle to maintain this weight off of the Glp-1. If not, screw it. Anyway, I am now indifferent to food. I’ll still cook, and when I place a food in front of myself at the proper time, I will eat it. But it does not have the (probably) abnormal importance it had for me before. It is much more understandable to me how others can suffer through a diet if this indifference is their baseline.
Lost maybe 30 lb with ozympic. At most 10 more lbs. Combination of fat and muscle mass. Justified by T2 Diabetes. Replaced synthetic insulin. A1C from 7.5 to 6. Apnea and snoring down significantly. No peripheral neuropathy.
Optimal diet for me now seems to be low carb breakfast and late supper. The trick seems to be to ask myself if I really am hungry or just want to eat, because I do find myself still eating to eat, and esp sweets, most esp chocolate.
For me, I am still very happy with the results.
Truth Number 1. Every medication is a path hacked through the unmapped biochemical rain forest of the human body. It’s an enormously complex and interactive system involving chemical physical, and even electrical signals.
We have just begun to map the genome and can name many of the hormones and proteins, but every medicine is basically still a shot in the dark.
Remember this – repeat it as often as necessary to counter the overweening confidence of our technological age.
Truth Number 2. If you have really internalized Truth Number 1 – it is a no-brainer to turn first to diet and exercise, and follow the obvious guidelines. You don’t have to go to extremes, but this is the safe, low-hanging fruit that gets you 80 percent of the way.
Stop smoking and limit yer $#%!$ drinking, forget about “medical” marijuana.
Eat food from a regular grocery store that is sufficiently unprocessed that you can identify where it came from.
Food your body evolved to digest.
Which leads to:
Truth Number 3. We are surrounded by an abundance of food – which means that heroic interventions are meaningless in the mid to long term.
We must make eating less a habit, a new normal.
It doesn’t matter if you are a “foodie” or not. Gournets can, in fact, treat this as a great creative adventure.
Buy smaller plates for daily use. Buy smaller pots and pans.
Stop automatically serving carbs with your meals. No problem serving stir-fry without rice or noodle.
Stop assuming you need “3 square meals a day” if you are not a roofer or a landscaper. Scale one meal back to soup or salad (no bread!)
Finally:
Truth Number 4. Resolve or redirect the emotional reasons you nosh… nothing wrong with enjoying food or using it to celebrate (we have splendid Sabbath meals each week) – but much of our eating is unmotivated or misguided, a poor solution (or non-solution) to some underlying issue.
I know other folks who lose their appetite when they get stressed, but my response to stress is just the opposite: it makes me hungry all the time, and I constantly want to be eating. Just another of the many ways that problems of controlling weight are complicated.
People are very different from one another in how weight gain/loss functions.
My wife wants and needs to lose at least 30 lbs. She’s tried, very hard to do so, even sticking on a diet for a year that left her hungry all the time. She lost 25 lbs, but when she quit the diet, gained it back. I think for her its a hormonal problem, as her weight gain came after a hysterectomy. Before that she was always slender. Her one weakness is Hagen Daz ice cream, otherwise she doesn’t overeat, and she limits herself by not buying it. If its not in the house, she can’t eat it. She’s also careful about not eating junk food.
I don’t trust the weight loss drugs, and neither does she. She’s not good at exercise other than walks, but they don’t seem to help regarding her weight. She’s kinda stuck.
As for me, I’m a devout foodie, but when I want to lose weight I just limit myself to one normal serving of whatever I’m eating, rather than eating (out of pure enjoyment) more than one serving. I don’t especially limit what I eat, although I go light on desserts and bread. I also try to not eat past 7 pm, and preferably 6 pm. One trick I do is brush my teeth right after dinner. Since I’m lazy, I don’t snack in the evening so I don’t have to brush my teeth again. It actually works 🙂
One habit I have is weighing myself every morning when I get up and every night at bed time. I write these weights down, and have years of daily weights recorded. What I find is that I lose from 1.5-2.5 pounds overnight (which happens naturally due to the body organs working all night–heart, lungs etc). So when I see the bed-time recording up more than I want, impacting the morning weight, that tells me to be careful the next day to counteract what’s happened the day before. I eat less or am more careful about exactly what I eat. Doing this may sound anal (my wife accuses me thusly), but I can maintain my weight in about a 3 lb range indefinitely.
I do go overboard on holidays, but using my method, after the holiday period I can get back on track fast. Sticking to not eating late helps immensely IMO even in the holiday feasting periods–it helps tamp down the amount of weight gain.
I’ll also say I stay physically active. At 81 I play pickleball 3-4 times a week, and do a regular core strength exercise routine that takes about 15-20 minutes, every other day. So far, so good.
The issue noted in the last block quote was the most alarming to me. Maybe the next generation of these drugs will be a molecule that targets fat only – although who knows what problems accelerating fat loss (even faster) could cause.
BenDavid,
I am a fan of regular exercise and have exercised regularly most all my life. And I agree it’s good advice for people. I think walking is especially good, if physically possible. We are bipedal and walking seems to have a positive affect on mood.
However (and unfortunately) the “exercise” part of “diet and exercise” isn’t holding up to science. Weight loss seems to be 99.99% diet. There are even some studies indicating too much exercise may make weight loss harder. If people are able, and have the inclination, doing some form of exercise regularly is great! I’m a big fan! But if one wants to lose weight current research indicates it’s all about food intake*.
FWIW, some general hints to eat less:
1. Eat more slowly, where possible, e.g., a) don’t eat alone, if possible, and talk to your fellow diner(s) during the meal; b) put less food in your mouth at one go, and then chew that food twice as long (or more) as you think you have to—indeed, your parents (or grandparents) were right DLL along….
2. Try not to snack (no, this ain’t easy). If you have to snack, snack healthy (also a challenge but the information is out there). Personally, I’ve become addicted to nuts, mostly walnuts, which I eat frozen (they don’t exactly “freeze”), and pistachios. Other nuts are also OK, but cashews, especially raw, aren’t highly recommended and Brazil nuts should be limited to only a couple per day because of their very high selenium content. (Remember that peanuts are legumes, not nuts.)
When snacking Try to keep in mind #1, above.
3. Try intermittent fasting, where possible. This is related to #2, above, but if you can end your evening meal at a reasonable hour and NOT eat until breakfast the next morning then you are automatically doing it, at least to some extent. (Remember: breakfast = break fast.)
Other suggestions:
4. If possible, (and especially if you have high blood sugar issues), try to start your meal with fiber (low-Glycemic-Index vegetables, e.g., salad with a quick, home-made vinaigrette; or relatively low-Glycemic-Index fruit) followed by protein, before starting in on the (low-GI, where possible) carbs. All categories can be accompanied by “good” oils/fats.
5. If possible, go for a walk after you eat. It doesn’t necessarily have to be a vigorous walk or an inordinately long one, but it DOES help to alternate your pace, e.g., “x” minutes relaxed walking followed by “y” minutes more vigorous walking, alternating repeatedly.
None of this is rocket science; and to make it more, um, palatable, one might be able to make a game of it, e.g., for #1b, the last one to finish the meal gets an extra portion of desert(?)—though there probably should be a cut-off point for this especially if the diners happen to be extremely competitive.
Lots of other tips out there, of course…
Barry,
I fast a fair amount and most every day have at least 12 – 14 hour window where I intake no calories. I do it because it fits my lifestyle. However, recent studies I’ve read are indicating it doesn’t help with weight loss and may have some negative health affects.
https://newsroom.heart.org/news/8-hour-time-restricted-eating-linked-to-a-91-higher-risk-of-cardiovascular-death
@Rufus:Weight loss seems to be 99.99% diet.
You’re just the messenger, I’m not blaming you, but I am astonished that this is “news”. All you have to do is compare calories in food vs calories burned by exercise. Any evidence that ever showed that thin people exercised more was at best correlation, not causation.
A healthy, fit, 30 year old who runs a mile burns about 130 Calories. That’s about two large eggs. Or a large potato, if you didn’t put butter on it. 1.5 tbsp of butter–or any other oil, no matter how healthy–for that matter.
If you eat one extra Krispy Kreme Original glazed donut you have to run a mile and a half to burn it off. There is almost nobody who tracks their Calories and does that much exercise in response–and the few exceptions are probably doing little else with their time.
As for losing muscle while losing weight, I don’t know any weight loss method that doesn’t do that. If there was some combination of diet and exercise that could do that, bodybuilders would know what it was. And as far as I know they don’t, rule of thumb in that community is to keep weight loss to 1 – 2 pounds a week to keep the loss of muscle and strength manageable.
— Bill
Again, easy to say, hard for people whose genes are saying ‘more!’ to do. For some people, exhaustingly hard.
The craving doesn’t stop just because you know mentally that you’ve had enough.
There are other considerations, too. One that is often overlooked is the constant advice to eat more fresh food and cut out the processed quick stuff.
The only problem is that a lot of people are already so pressed for time that it’s just not practical advice, most days. When you get home past six or seven and you’ve got to get the kids homework done and them ready for bed and deal with the taxes and the bills and make sure the furnace gets repaired before the cold weather arrives and you might want to spend 5 minutes with your spouse, that leaves you about 15 minutes to make dinner.
Health advocates like to point out that healthy food doesn’t have to be more expensive, or not much, and that’s true.
But just as they’ve failed to find a way to make healthy diets fully satisfying and enjoyable for most people, they’ve yet to find a way around what I call the ’15 minute limit’.
Rufus, thanks. (But can that right-hour IF study possibly be right? Maybe it refers to fasting during the day: otherwise, most of us should be already dead…)
But yes, the spectrum is broad, and it’s possible that intermittent fasting may be overhyped.
Certainly, since some people have faster metabolisms than others (and/or smaller stomachs due to medical procedures or other reasons**) it’s possible that the longer fasting periods touted by some (e.g., 14-16, or even longer) are not at all advisable or recommended.
In addition, intermittent fasting takes quite a bit of discipline (related, as it is, to eliminating snacking between meals or cutting back significantly); but I think a fasting window of, say, nine or 10-12 hours—most of that time while asleep—is something that should, at least, be attempted, with doctor’s guidance/supervision and for some, NOT “cold turkey”.
Yes, one may well feel hungry at first; but if the goal is to eat less, one has to start somewhere; and it makes sense to exploit that period of sleep, which is when one’s metabolism slows down automatically.
Oft-given advice is that to lessen hunger pangs—and for general health reasons—no matter which path one might choose, is to “hydrate” (i.e., drink water) regularly, and not only when one feels thirsty.
**There is a group of people that are advised—for whatever reason—to eat more frequently, even four to five times a day, but people in this category generally understand that those meals should be smaller, though as nutritious as possible.
A few years ago I lost 60# in 18 months on the Slow Carb diet. I regained about 15# but as long as I can fit into my 34 Levis I’m not worried. I do a loose version of Slow Carb these days.
* Three small meals — protein, veggies, beans — four hours apart. One doesn’t feel hungry. It keeps one’s blood sugar steady.
* One cheat day per week. Takes the psychological pressure off. Prevents the body from dialing down one’s metabolism to compensate for dieting.
https://tim.blog/wp-content/uploads/2019/07/tim_ferriss_the-4-hour-chef_one_pager_slow_carb_diet.pdf
I still enjoy my food but I don’t have as much appetite these days. I can’t eat much before filling stuffed.
Oops. Should be “…eight-hour study…” (instead of “…right-hour study…”).
Related (insofar as “health” is related)…
…AND ALSO, A MUST READ…
(…for all kinds of reasons, mostly but not entirely COVID-related, a critically—vitally—important article.)
“The Secret Campaign To Stop RFK Jr.”—
https://www.zerohedge.com/political/secret-campaign-stop-rfk-jr
Hmm. Could it be—COULD IT BE??—another true…conspiracy?
I think we (humanity, or at least Americans) are hoist by our own petard. Eons ago, out on the veldt, we were opportunistic eaters. Killing animals, finding the bushes with the good berries. and in between, out bodies sustained us by burning fat we’d built up at the last meal.
But our big brains led us to strive to always have enough food. Agriculture, domesticating animals, then food distribution, refrigeration, preservatives (salt, to start), all of it leads to a society where it’s almost impossible to starve, except it hasn’t been long enough for evolution to change our hardwiring from opportunistic eaters trying to avoid starvation.
We’re caught, and I don’t know how we get un-caught.
I enjoyed BenDavid’s comment on “Truths.” And agree.
However (and unfortunately) the “exercise” part of “diet and exercise” isn’t holding up to science. Weight loss seems to be 99.99% diet. — Rufus
Well… I agree diet is the majority of the issue. However, exercise is a significant factor.
I started using All Trails walking/hiking app recently. My most recent walk from several days ago (I had lots of things going on over the 3rd through the 6th holiday period) generated these stats.
Distance: 5 mi.; Walking time: 1:38; Elevation gain: 482 ft.;
Calories burned: 852
852 isn’t nothing. Another point is that there is a significant difference between relatively static “activities.” Standing still, sitting upright, stretched out on a couch, and sleeping all consume calories, but in rather different amounts. One can watch TV for some time, while standing and maybe stretching a bit. Extra calories burned.
@TommyJay:Distance: 5 mi.; Walking time: 1:38; Elevation gain: 482 ft Calories burned: 852
Most people are not going to have a 500 foot hill to climb behind their house, and 100 minutes to spend climbing it, every day. They might get to do such a thing once or twice a week, and spend a bit of time going to and from it. And while 852 Calories is not “nothing”, it is very easy to overeat it. 2 cups of ice cream would do it.
In the days when most people had to do hard physical labor most of the day to eat the next day, and mostly had access to seasonal foods that they probably produced themselves, it was easy to exercise enough to offset your diet. Nowadays it is harder, though it can be done, if you are retired or if you are a Hollywood actor who needs to lose weight for a role. Bodybuilders who are very serious bodybuilders do little but exercise but even they have to carefully manage their diets, because they have to eat more than they need to gain muscle, but not so much they gain fat.
NC,
Bodybuilders are not a good example. They have extreme diets not only for the extra protein but for the goal of extraordinarily low body fat. So that they look “cut.” Quite often, they are not that healthy or athletic.
Absolutely true about 2 cups of ice cream. I know that one from personal experience. Ha. I did say diet was the majority of the issue. My other point was that one does not need higher levels of exercise (like climbing my steep hill) to elevate your calorie burn significantly. Gentle walking and just standing more helps too.
If a person is 70 like me, then there’s a good chance they can devote a larger chunk of time to exercising, if they wish. What do you really want? What are you willing to do? It comes down to discipline, determination, and exercise, IMO.