My wife, on the other hand, is uninsurable. If she wasn't covered by Medicare (a federal program), her only option would be to be employed by a group policy at her employer or be married to someone whose employer offered group policies for the families of workers. And the only reason that she's on Medicare is because she's considered to be too disabled to work. Here's the kicker.  If she had a chronic illness like diabetes or heart disease that didn't prevent her from working, she'd not qualify for Medicare and still be uninsurable except through group plans offered by various employers.

Yeah, it's messed up. I think there are two good approaches to solved the  problem. One method is some sort of single payer system at the federal level. Another method would be for legislation that made insurance into true commodity by forbidding riders so that specific conditions aren't met, that all buyers into the system pay the same price, that individuals can't be rejected due to age, occupation or pre-existing conditions.

If you had CBI plus a small, simple set of extras, then it could work but keeping it simple is a challenge.

You can't inspire people with facts
- Small Gods

If you eat too few calories your metabolism starts to slow down.

This is a propositional formulation of an inherently quantitative claim. It could be claiming that if you go 500 calories short your metabolism slows down enough to economise by 500 calories. It could be claiming that if you go 500 calories short your metabolism slows down enough to economise by 100 calories. As I unpack it you also notice an implied time scale, which is unclear but which might be weeks.

Coming up with a propositional formulation that straddles two importantly different quantitative accounts is a very effective way of de-railing a dialogue. Here is how it works.

I have to interpret your comment. If you go 500 calories short and your metabolism slows to the extent of economising 100 calories then the weight loss program is only 80% effective. But that is plenty good enough. So that interpretation doesn't make sense in context because it doesn't refute my suggestion that not feeling hungry is an opportunity to go under the calorie count and lose weight faster. It merely points out that it will be less than 100% effective.

I have to go for the other interpretation, a calorie for calorie match between restriction and metabolic economy. That is the argument that responds to my suggestion of going under the count when you are not feeling hungry. It is a poor argument: if it were true it would apply to calorie restriction diets in general and prove that they could not work. So I have to call you on this bad argument.

Now the context has changed. Earlier "starvation => lower metabolic rate" was in the context of "don't eat when you are not hungry". Now it is in the context of an abstract debate of the truth of the proposition "If you eat too few calories your metabolism starts to slow down.". I'm going to lose that debate because the propositional formulation is ambiguous enough to include quantitative versions that are true.

So there you have half the story of why I'm inclined to shrug, make a snarky comment (sorry) and walk away from the keyboard.

What is the other half? I've picked up the impression that exercise is a vital part of any weight loss plan, vital in two ways. First, it stimulates the production of hormones, preventing a general reduction in metabolic rate. Second, the point of the weight loss plan was to feel better and live longer. Exercise seems to directly help with these goals. If you take exercise you will probably feel better and live longer even if you fail to lose weight.

My offering to you was the intriguing observation that the usual idea of strict calorie counting sets up a dynamic that punishes exercise. You go out on your bicycle for your scheduled exercise. It is a sunny day, your mood soars, you race up hills, swoop down the other side, and generally burn more calories than the plan calls for. Come dinner time you don't allow yourself any extra. You are already hungry because you are on a diet. The extra exercise tips this over into painfully hungry, and you start to sour yourself on doing exercise. Next time you will just go through the motions and be careful not to burn too many calories.

Now I maybe took this too far by being a completest. If you need to respond to being more hungry than usual, maybe you also need to respond to being less hungry than usual. Maybe not.

The point that is worth discussing is how to do calorie restriction without training yourself to hate exercise.