Diet Thread

[mikesbytes]

I've just read through a lot of these posts for the first time.

I'll be honest, the 'general' information in them isn't something that I haven't heard before. But I'm as stubborn as the next guy, and I find it hard to give up things that are enjoyable.

However, it's also become increasingly apparent that unless I make a change, nothing will change. I'm reading up on the Blue Zones, and Whole Foods Plant Based diets. I'm going to benefit, and as the primary food maker in the house, my family will benefit as well.

I have religious leanings that head towards these type of diets as well, however that's another story for another day.

I appreciate the effort people have put into the information provided on here. Please forgive me if I start asking what appear to be very basic questions. It's a lot to take in as a whole, and there's a lot of life habits that need reshaping.

Now, on to read some more articles...

As you can see there's a lot a approaches and those who believe in one approach disagree with the other approaches.

If you went to the doctor with the bug, the doctor gives you a script and your purchase some tablets which you consume and the bug goes away. If you go to the dietician [not all of them] and say you have this problem then the dietician gives you a diet and sends you away then most fail to follow the diet and the reason is that your are use to eating in a particular way.

So I ask the question, if you see the blue diet [for example] as the way forward for you, then how are you going to adjust/adapt yourself to get there? Its a bit like giving up smoking, there's a number of different paths and only one of those paths is going to work for you, but which one

[Brendo09]

So I ask the question, if you see the blue diet [for example] as the way forward for you, then how are you going to adjust/adapt yourself to get there? Its a bit like giving up smoking, there's a number of different paths and only one of those paths is going to work for you, but which one

That's the million dollar question.

Here's where I've gone in the lasts six months. Add a cup of full cream latte (no sugar) with each of these, and maybe 1l of water all up.

Breakfast was toast, usually around 4 pieces.
Morning tea was crackers with butter, or a toasted bun from whichever cafe I was near.
Lunch chicken and avo focaccia or chinese takeaway or similar
AFternoon tea more crackers
Evening meal was with the family and was often meat (chicken schnitty, sausages, fish shaped fish things etc) steamed veg (carrot, peas and corn) and mashed spuds.
Often a warm drink with a few sweet biscuits around 9-10pm (think Scotch Fingers, Nice etc)

I now eat a packet of weetbix go biscuits for breakfast (5 biscuits I think per packet). A banana if there's one left over.
Morning tea is just a coffee
Lunch is a sandwich with more leafy greens (spinach leaves for now) and pickled onions, sourkraut, relish
Afternoon tea usually a few dry crackers, no butter
Evening meal is similar though we're going for a cooked chicken breast instead of the prior meat flavoured things

There's still a coffee per meal over the course of the day, and still around 1l of water.

That being said, there's still a hot chips meal once a week after the kids finish swimming, and probably a KFC of McD meal (which I'm trying to stick to small burgers and no chips or drinks... I used to smash the lot). No soft drinks, no sugar in my hot drinks, rarely icecream, no lollies for 6 months (that was a 2nd drawer special at work).

Now I can see that I've got a long way to go. As much as I love coffee and have several thousand dollars of hardware in the kitchen, I think that's a logical step to remove. add an additional litre of water. Cut out the bread as well, and just have the fillings on a small plate. Instead of crackers chop up an apple or a mandarin, and create more leafy salads for the evening meal, or vegetable soups (i can make a mean roast pumpkin soup).

I'm just getting tired of feeling tired. I'm not a grumpy person, I just feel buggered all the time and have a rotten body fat level that I've only ever been able to lose by massively restricting my eating. I went from 120kg to 104kg last year, but I simply stopped not eating one day and was all back before I knew it.

That and my body needs to do more physical work. Hence the cycling part (even if only indoors for the next few years until the kids are more independent) and the body weight exercises.

[march83]

Full disclosure, I'm WFPB and having done all the other fad diets (calorie counting -> keto -> paleo -> vegan) I think it's the only one that actually works.

You eat more servings of processed grains in a day than I eat in a month. You could ditch all that and eat several times the weight in vegetables and feel much more full. Guiding your eating habits by calorie density IMO is one of the easiest ways to diet and I'm surprised it hasn't been latched onto as a dieting fad in and of itself. If it has less than 100cal per 100g it's good. less than 50cal per 100g it's great. Off the top of my head, the only things I eat with >100cal/100g are avocados, flax seeds, nuts and legumes. Very hard to eat 2000cals when your average calorie density is 50cal/100g: that's like 4kg of food a day!

You seem to have bigger problems than coffee, but you didn't say how many cups you drink a day. It's worth remembering that every cup is physically putting your body into a hormone driven panic mode - cortisol has impacts on insulin sensitivity, body fat retention. Too much coffee too often messes up your adenosine receptors and at that point coffee stops keeping you awake so much as it is essentially required just to allow you to feel normal. Personally I can fit 2 cups of filter into my day without too much issue. If i get up to 4 cups a day then I'm heading for a crash. Don't sell your nice gear, just learn to love decaf and learn to love seed milks (oat and almond both texture pretty nicely and taste really good once you get used to them).

Fast food is a lifestyle problem. I've got young kids too, but we don't do any of that Maccas/HJ/KFC stuff. If we do eat on the run it's sushi or a friendly cafe - I can always find something vegan in either type of place and they can load up on relatively healthy options. I hear a lot of parents say that they only eat fast food because they have to take their kids there, but it's the other way around - the parents are meant to be teaching their kids and if they end up at Maccas then it's a terrible lesson by example.

How are you currently getting to work? Can you commute by bike? If it's practical, maybe you can trade 1hr in the car for 1.5hrs riding and not have to spend time sitting on the trainer at night when you could be spending time with the kids?

[rapunzel]

My child is about to turn three and does not know what fast food is yet other than one pizza takeaway place. He does know burgers - mine and one restaurant (BBQ place so he can have slow cooked beef if he wants). Other than that, his fast food is pho at a Viet place.

He would not touch pizza, burgers or chips til 2.5yo. No idea why. His choice. We don't offer them much, so possibly a reason.

He thinks Apple juice at a restaurant is a huge treat.

That said, I allow him doled out chocolate treats, ice cream cones at home (some of the ice cream I have made), we make cookies, cakes, brownies together. He knows when he is full and will hand over an ice cream cone half done if he is not hungry. As someone who deals in feeding skills, having a child who knows when he is full is a win. And a child who eats massive veg and fruit, the same. Toddlers are notoriously fussy, those with developmental delays, more so.

For parents in a rush - because I find meal planning, shopping, and cooking take up way too much time- I now actually defer to the store brand coleslaw mix with carrot, red cabbage, beet, daikon, kale. You can remove the dressing and add yr own if you like. Parents cooking on the run should be a focus on healthy eating pans and help...

[CKinnard]

I'm just getting tired of feeling tired. I'm not a grumpy person, I just feel buggered all the time and have a rotten body fat level that I've only ever been able to lose by massively restricting my eating. I went from 120kg to 104kg last year, but I simply stopped not eating one day and was all back before I knew it.

That and my body needs to do more physical work. Hence the cycling part (even if only indoors for the next few years until the kids are more independent) and the body weight exercises.

Brendo, that fatigue is classic insulin resistance driven though a good idea to get a GPs input (blood tests)
Mate, your diet still needs lots more nutrients.

Usually dietitians will put men on 1500 Calories per day, and adjust that up or down so you lose 1/2 to 1 kg a week.
If you have quite a belly, you could try 1200 Calories/day.

Below is a link to a 1200 Cal diet plan I've been recommending for over 15 years, developed with a sports dietitian.
It is mathematically correct.
If you want further direction, ask.
https://drive.google.com/file/d/0B3Z-nJ ... sp=sharing

[Nobody]

Evening meal is similar though we're going for a cooked chicken breast instead of the prior meat flavoured things

Probably good to keep in mind that blue zones people eat < 300 grams of animal flesh a week, down to none at all.

Now I can see that I've got a long way to go.

Yes, but so did most of us in the beginning.

I'm just getting tired of feeling tired. I'm not a grumpy person, I just feel buggered all the time and have a rotten body fat level that I've only ever been able to lose by massively restricting my eating. I went from 120kg to 104kg last year, but I simply stopped not eating one day and was all back before I knew it.

Well the diet should help both problems as most people who change including myself say they can deal with lack of sleep much better after changing. I feel on average more awake during the day. I'm also just under ideal weight for height. I started out about 20 kg heavier, in the average overweight range. It's a diet where if followed with a low calorie density, then you can eat a large amount of food, feel satiated and yet stay at an ideal weight.

That and my body needs to do more physical work. Hence the cycling part (even if only indoors for the next few years until the kids are more independent) and the body weight exercises.

Exercise is important, but don't make it your focus. The focus should be getting the details of the diet correct if you want to succeed. On average weight loss is 78% diet and 22% exercise. For health, diet is more important than exercise. So I prioritise diet over exercise.

[mikesbytes]

Excellent progress Brendo, you have made a good transition and are thinking about the next step, its a case of figuring out what is going to work for you to continue your excellent progress. One thing that worked for me was adding vegetables to my breakfast an unusual step I know, I can't think of anyone I personally know who's done this.

March has giving the details on the coffee and I'm a coffee luver too so I'm getting what March has mentioned. Adding to that, if your making cappuccinos they typically have around the same calories as a can of coke, ie 175, so an option is to swap to black or put a dash of milk in it.

[Nobody]

You eat more servings of processed grains in a day than I eat in a month. You could ditch all that and eat several times the weight in vegetables and feel much more full.

Likely with less calories consumed.

Guiding your eating habits by calorie density IMO is one of the easiest ways to diet and I'm surprised it hasn't been latched onto as a dieting fad in and of itself. If it has less than 100cal per 100g it's good. less than 50cal per 100g it's great.

It's a useful tool, but not fool proof IME. If you don't get the macros correct eating ad-lib, it can be overridden. You need to get all your ducks in a row, so to speak to get the results. Dr Rolls is credited with the study of the concept of calorie density, but she doesn't look very thin to me.
http://nutrition.psu.edu/foodlab/barbara-rolls
In other words - for the new players - one needs to keep the fat and protein low and the carbs whole for calorie density to work well.

[CKinnard]

It's a useful tool, but not fool proof IME. If you don't get the macros correct eating ad-lib, it can be overridden. You need to get all your ducks in a row, so to speak to get the results. Dr Rolls is credited with the study of the concept of calorie density, but she doesn't look very thin to me.

In other words - for the new players - one needs to keep the fat and protein low and the carbs whole for calorie density to work well.

I agree with Nobody here. Just changing to healthier choices doesn't ensure weight loss.
I know a lot of WFPB eaters who are overweight.

After dealing with hundreds of clients, I think it is preferable for clients to be shown what a balanced diet is with appropriate Calories. There doesn't have to be any Calorie counting by clients if a clinician spells out the serves or meals, as I did in the diet program I linked to above.

Nobody, I thought you were being harsh implying barbara rolls is overweight, so I did google image search.....and have to agree.

[Tequestra]

Studies are proving that if the subject makes sure to cook a good breakfast in the morning, with lots of vegetables which contain enough vitamins for its survival, that a simple block of chocolate is enough to maintain the sedentary subject throughout the night.

This subject has been worried that it may catch the 'flu or some other viral malady, but after a week of cold winter weather and regular shivers, the subject is confident that along with a good breakfast in the morning, and warm clothes throughout the day, a block of chocolate at night is a most economical method of maintaining enough glucose to properly defend the subject's somatic immunity from common Australian urban virii.

The subject wishes to inform the forum that it has no commercial relationship with Cadbury nor Lindt nor any or the other brands tha Aldi sells, but it would not mind if it did because then it could afford more of that sweet chocolate at night which is has no detrimental effect on rotten teeth after a good dose of Listerine before bedtime.

You can spend more money on your bike if you eat chocolate for dinner.

[Nobody]

Nobody, I thought you were being harsh implying barbara rolls is overweight, so I did google image search.....and have to agree.

Not trying to be harsh. Just trying to call a spade a spade, to get a point across. As you know, one can often perceive the long term effect of a diet concept by analysing the author's shape.

Novick has applied calorie density to WFPB and together, with enough attention to detail, they appear to work well. Of course there are more pieces to the puzzle to get the ideal diet for an individual. Much of which may require trial and error, and blood testing by that individual. For fine tuning over time.

I suppose I've followed Novick's leadings more than any other WFPB diet author over the years. I should be pointing more people in his direction.

[CKinnard]

...trying to call a spade a spade....

Most pics of BRolls are waist up, in which she looks healthy weight (by scientific and historical standards).
However, the overwhelming majority of females store fat first and most on their buttocks and thighs (males in and around their gut).
And she is carrying excess in those areas.

I find the the push by mainstream media and 3rd wave feminism to normalize "bigger girls" an interesting and sad phenomenon.
It's the mindset of people who know the value of nothing, and peddle it as empathy. When humans look back on this chapter in history, they'll paint it as when adults believed in nothing, slaves to Freudian Id impulse.

One may well ask themselves why we do not see examples such as below on prime time television regularly.
Why is the woman below not celebrated and used as an example for all females to emulate, by 3rd wave feminists?
Why do today's agitating class not busy themselves investigating this woman's lifestyle choices, and promote them?


or Ozzy Man's better narrated version
https://youtu.be/PHyGRM7NR38

I have been working closely with a specialist pediatric nurse for the last 4 months, and shared some disturbing insights.
I also have had several illumining conversations with a child care worker who has been in the job for 27 years.
Both ladies have seen the rate of obese mothers escalate alarmingly in that time, and babies and toddlers have simultaneously developed a higher rate of developmental issues - autism spectrum disorders, allergies, toe walking, tongue tie and other oropharyngeal malformations.

While capital city elites run headlines that stir emotion, more devastating social issues are ignored presumably because they aren't as powerful click bait. Maybe the masses already know of these issues, but have no will or understanding of how to escape the forces that enslave them.

Ah well, as always, my final thought must be physican heal thyself.

[Nobody]

When humans look back on this chapter in history, they'll paint it as when adults believed in nothing, slaves to Freudian Id impulse.

Yep. As sad as it appears to be. That seems to sum it up.

Met a guy tonight who said he has rheumatiod arthritis. Told him the best thing he can do for it was to stop eating animal products, as it will only reenforce the drive of the faulty immune system. As he was one of the almost ubiquitous majority who doesn't think he should deny himself life's pleasures, I suggested he do it by substitution. Still didn't seem very keen. Businesss as usual. It's a struggle to get people to help themselves. Too much food addiction. Slaves to impulses, as you said above. Oh well...

[CKinnard]

Still didn't seem very keen. Businesss as usual. It's a struggle to get people to help themselves. Too much food addiction. Slaves to impulses, as you said above. Oh well...

yeah. I often feel like I am on the wrong planet.

it says a lot that chimpanzees and gorillas eat a healthier diet than humans.

[Nobody]

https://www.smh.com.au/national/dementi ... 4zkeh.html

Another reason not to wait to improve your diet and get some exercise. IMO we are, in essence, the sum of our cognitive processes and memories. Once we lose our memories, we effectively become an empty shell. Which makes it difficult for our children while they work/battle to look after us and wait - maybe for quite a few years - for us to finally die. It's a sad outcome that one of the people at my work is dealing with currently. His father, in his '80s, has had a series of mini-strokes and now doesn't even know who his son is.

Someone once posted on here that you don't want to get an award for the oldest person in the nursing home. I'd argue that you don't want an award for being the youngest, or having the longest stay either.

[CKinnard]

Someone once posted on here that you don't want to get an award for the oldest person in the nursing home. I'd argue that you don't want an award for being the youngest, or having the longest stay either.

yes I read that link, which is pretty much a nothing article.
all comes back to lifestyle choices....wow!

as baby boomers age, alzheimers is the new cancer.
the media love to stir up fear by profiling a particular disease....it's all click bait.

yes, some idiot always raises the 'no prizes for being the eldest in the nursing home'.
these zombies don't comprehend the alternative in all its forms.

[Nobody]

This video is longer (at almost 20 minutes) but worth a look. I found it interesting that he proved in at least one case that BMR fluctuations can be temporary, both up and down. Where "The Biggest Loser" BMR study suggested that BMRs had become fixed at a lower level. Considering the ex-contestants were following the "backing themselves into a corner" approach of continuing to reduce their intake and at least maintain their exercise, as they had been taught on the show. It now doesn't appear surprising. Andrew shows a better way, which include some studies at the end.



This also ties in with what I've learnt elsewhere, that changes are best done gradually and subtly over time. This way the body doesn't get too much of a shock and resist that change.

[CKinnard]

hmmm... yes I noted Andrew's vid when it first came out (am subscribed to him).
I keep it in mind he is not formally schooled in this area.
His points in this vid are :

- long periods on LCD reduce BMR significantly
and one may not lose weight on supposed deficits such as 900 Cals.
I have had clients tell me the same (and even not lose weight on 500 Cals/day), but I have never policed their Calorie intake to back it up.
Many studies show people are notoriously unreliable at monitoring Calorie intake.

- to continue losing weight or maintain a desired goal, one can increase their Cal intake and simultaneously increase activity levels.
Now this is where I think Andrew errs in generalizing.
The studies he refers to were with university aged students, not 30+ year olds who have different lifestyles, stressors and associated endocrine states.

Further, most people over 30 are severely limited in the time they can devote to exercise over a week. Of the thousands of people I have seen in clinic, about 2 in 100 over 30yo would have the drive and time to consistently do >5hours a week, but this 2% don't have significant weight issues.
An average weekly time for exercise for committed over 30s is more like 3-4x 45minute sessions a week = 2.6 hrs/wk

Averaged exercise intensity over those sessions rarely exceeds 5 METs (5xBMR)
5 METs is a very fast walk or medium paced jog.
Weightlifting, calisthenics, Pilates, Cross Fit all average <5METs due to regular rest periods.

This results in a typical overweight female not being able to burn more than an additional 200 Calories a day.
Net exercise = (5exMETs - 1BMR MET ) * 3/4 hour = 3 METhours
Net additional Calories per day = 3 METhours * 0.85Cals/kg/hr * 75kg = 191 additional Calories/ EXERCISE day
which averages out to 95 Calories per day over a week.

So if hypothetical Cals in/out cannot be generalized as Andrew attempts, what explains his experiences?
My perspective and that of much physiology and metabolic literature is even 3-4 hours of exercise a week helps to normalize endocrine and sleep function, and blow off fight/flight stress effects....thereby reducing appetite, especially for feel good foods that stimulate serotonin and dopamine pathways.

Gaining muscle helps lift BMR but not as significantly as many believe.
Over a day, studies show fat tissue typically burns 5Cals/kg, and muscle 20Cals/kg (note this is not resting energy expenditure)
However, the average person embarking on a resistance training program gains 2-3kg of muscle. Let's say they replace 2.5kg of fat with 2.5kg of muscle -> an additional Calorie burn of 37.5 Calories per day! By any measure, that's not significant, and is detail Andrew needs to temper his paradigm with.

I've seen too many people embark on exercise programs, and burn their knees, hips, or back out in order to lose weight.

And I've seen many people lose weight just by managing stress better and having more meaning and love/security in their lives.
So what's the middle way to losing and managing weight?

1. Work on your internal locus of control. Resist the rush and misplaced priorities of those around you, and strive to be the authority of yourself at every level (mind mood and appetites). Regularly still yourself or withdraw from the stimulation and intrusion of the world. Self Mastery is a concept rarely talked of in this day and age.

2. Identify your stressors, and deal with them NOW...extinguish them by clarifying your values and setting resonant life priorities and goals.

3. Maintain a reasonable level of activity 3-5 hours a week for cardio (even walking/cycle commuting) and resistance ex (even gardening and yard work).

4. Think of your body as a temple or machine, and think of food as fuel and oil....and aim to put the best stuff in, realizing that our appetites get dysregulated and crave stuff that damages the machine. Remind yourself that the more contentment you get from what you do in life, the less you will seek contentment from food.

5. To re-regulate mind and endocrine state, consider several times a year fasting, even if for 48 hours. But do it in conjunction with stilling the mind and withdrawing from the world.

[CKinnard]

On another note, an advantage a clinician gets regarding diet, is we see people from all walks of life with all states of pathology.
This year alone, I've had at least a dozen clients who have had either of a gastric band,sleeve, or bypass operation....and 4 failures followed by 2nd procedures.

One current patient had a band initially. that failed then was revised, only to fail again...then she got a bypass.
I've taken an extensive history and it stuns me how little these people are told about adverse effects, failure rates, and alternatives re diet.
Due to the smaller amount of food these people can eat in one sitting, and interruption of normal digestive processes, it becomes a serious challenge for them to take a healthy amount of "whole foods" with adequate fiber and micronutrient.
I've spoken to 2 dietitian friends about this issue, and it is outside their scope, and considered a specialty, which surgeons tend to develop lots of high profit protein powders for.
This one particular client has a lot of generalized arthritic pain, and bloated gut, and I have no doubt her microbiome is out of balance and she has endotoxins leaking into her blood stream and stirring inflammation. This is the price patients pay for medicine being as compartmentalized as it is, and lifestyle choices not being given the priority they deserve.

[Nobody]

I've seen too many people embark on exercise programs, and burn their knees, hips, or back out in order to lose weight.

The "cure all" attitude toward exercise is something I'm trying to rail against lately. As usual "the illusion of knowledge" is at play, which appears to be pushed by some food/drink companies trying to shift the blame. Yes exercise is an important component, but diet is much closer to a "cure all" than exercise. Yet because exercise is placed in such high regard, diet is pushed to an "also ran" when it comes to losing weight and gaining health. I even get quizzed about the amount of exercise I'm doing when people notice I've lost weight. The usual answer is the same, or less than usual.

IMO people that eat poorly will get more joint damage from being overweight and have slower joint recovery after exercise. Better to eat well first. Lose the weight and inflammation. Then gradually start or increase the exercise. Also committing to do exercise can take away from our willpower to reform out diet. Since studies have shown that willpower is in finite quantity. I prioritise diet over exercise and my results show the benefit of doing this.

And I've seen many people lose weight just by managing stress better and having more meaning and love/security in their lives. Of which diet style is a factor, since this can effect how calm one feels. So this can be circular.
So what's the middle way to losing and managing weight?

1. Work on your internal locus of control. Resist the rush and misplaced priorities of those around you, and strive to be the authority of yourself at every level (mind mood and appetites). Regularly still yourself or withdraw from the stimulation and intrusion of the world. Self Mastery is a concept rarely talked of in this day and age.

2. Identify your stressors, and deal with them NOW...extinguish them by clarifying your values and setting resonant life priorities and goals.

3. Maintain a reasonable level of activity 3-5 hours a week for cardio (even walking/cycle commuting) and resistance ex (even gardening and yard work).

4. Think of your body as a temple or machine, and think of food as fuel and oil....and aim to put the best stuff in, realizing that our appetites get dysregulated and crave stuff that damages the machine. Of which previous poor food choices contribute, due the addictions we have developed from them. Remind yourself that the more contentment you get from what you do in life, the less you will seek contentment from food.

5. To re-regulate mind and endocrine state, consider several times a year fasting, even if for 48 hours. But do it in conjunction with stilling the mind and withdrawing from the world.

\
I note that 4 out of 5 points are mainly psychological and in the remaining point also affects the psychological state. All the problems appear to be stemming from a lack of self control and knowledge. We can help with the knowledge aspect on these threads. But in the end, it's a case of "you can lead a horse to water..."

Having said that, two security guards at work have started to change their lifestyle patterns. So maybe the drip feed effect is starting to work. I think the turning point was when I started to use the "illusion of knowledge" saying to really discredit what people think they know about diet and undermine the trust they have in the system.

[Nobody]

...This is the price patients pay for medicine being as compartmentalized as it is, and lifestyle choices not being given the priority they deserve.

Though it doesn't hurt the medical profession's bottom line (pay for service). If it did, they might be more inclined to change it. To me the world runs on inefficiency. Some appears to be inherent, some orchestrated. If everything worked as it should, I'd probably be out of my current job too. Not saying any of it is necessarily good. Just the way it is.

[mikesbytes]

The vast majority of those I train do not have excess weight, they are not there for weight loss. Often those who are smart with exercise are also smart with nutrition.

If one is injuring knees, backs, whatever then they are either doing the wrong exercise for them or doing the exercise wrong or both. Those people are keeping Physio's etc employed.

Pilates isn't about weight loss, yeh I know there are some who market Pilates incorrectly, the same sort of people would market pretty much anything incorrectly.

I've got yet another obese ex premier Rugby League player doing aqua classes with me. He has decided to fit a band (actually a sleeve, must be a new technique I guess) and has had good progress loosing weight, he says that he doesn't feel hungry. He hasn't mentioned any side effects yet, I ask him hows it going every so often, if he does have problems I'm sure I'll know.

[march83]

I consider bands and bypasses as a pretty poor option due to the options above - MiL eats far too much, is morbidly obese and has terrible knees buy keeps saying that it's ok - when she's ready she'll just get the lap-band and everything will be fine ... but ... they do have a decent success rate according to studies. People having surgery statistically do better than diet and exercise groups partly because of changes to leptin sensitivity - these are still the minority though

[Nobody]

I don't understand the mentality of people who would rather have an operation than change their lifestyle for the better. There is always the risk of a serious infection, or other complications. IMO it's not logical (for those like your MiL who would know the options) so it's likely to be the pull of her food addictions are too great.

[march83]

Nor do I. And of course there is no logic to it - we constantly remind her that she's making choices now that will be the difference between seeing her grandchildren's 21st birthdays, their weddings, their kids, etc, or not, but she scoffs at the suggestion with pithy comebacks. We suggest that her knee problems would probably be much less severe if she ate better to reduce inflammation and lost weight to reduce the load, but similarly she's convinced that that she doesn't need to change and that a knee replacement will magically fix everything.

It's unfortunate though because she's not a picky eater. She goes vegan for lent every year and loses weight and feels energetic, thrives almost, but as soon as it's over she's back to her old self again eating far too much, far too many calories (added oil and butter, above average meat consumption) and she adds far too many empty calories (breads and pastas). I'm sure she does her fair share of snacking on garbage at work and I'm pretty sure she moderates her eating around us (she's very narcissistic so she thinks everyone is judging her all the time, which I suppose in this case is true...).

I'm sure addiction is the bulk of it, there are also cultural issues. Any suggestion that she may need to change the way she eats is an affront to her cultural heritage, as if the way she cooks now is some sort of historical legacy that cannot be adulterated. The reality of course is that she eats a handful of meals true to her heritage, but the rest are already westernised and adulterated into horribly calorie dense monstrosities. She also eats enough western meals that it wouldn't matter how healthy her native meals were, the damage is already done.