I wish the author had continued their rigor in reasoning throughout the two blog posts. Step by step the author is lured into proving a single factor explains the rise in obesity. That maybe a futile attempt from the outset.
To make an example, the author notes, correctly and to the point,
> "Calories are involved in the math but it’s not as simple as “weight gain = calories in – calories out”."
but then moves on to claim that "X provides evidence against CICO" when in fact the article cites numerous examples where an increase/decrease in calories results in a (short-term) increase/decrease in body weight. So what the author really meant was "X provides evidence against CICO as the single factor".
I'm not an expert in nutrition science but it seems very unlikely that a single factor (sugar! trans-fats! exercise! genetics!) will explain a real-world, highly non-linear phenomenon. I personally find the paragraphs where the interactions of factors are discussed the weakest and least convincing.
That is not to say the article is excellent and hammers home two very important points: Firstly the idea of the lipostat and as a result a short and a long-term time scale ('system') for body weight gain/loss. Secondly that factors relevant on one time scale may not be relevant to the other time scale. And of course that there is still a lot we simply don't understand (yet).
Others have mentioned gut biomes... My uneducated guess is plastics or some other chemical that was introduced into industrial use in the 20th century. The cross species effect (lab and zoo animals getting father on the same controlled diets) is also a really big clue that were dealing with a molecule. And, as with lead poisoning from gasoline, perhaps a hard to pinpoint one due to prevalence.
There is certainly some diminishing returns effect but it seems much less important than kcal in-kcal out.
Perhaps it's still not a single factor (which, I agree, would make a lot of sense) but IIUC that does raise the question of why there seems to be a single inflection point.
Most of the pleasure of eating and drinking comes from the first few bites and sips, after that the senses start dulling and diminishing returns start to set in, so it's really no big loss to stop when full. Certainly not worth getting indigestion over.
A few weeks of disciplined eating seriously diminishes the urge to overeat, but all it takes to settle into old habits is a single slip-up. I think making food artificially unpalatable by cutting salt, fat, or whatever ingredient is currently being vilified is just unproductive. It will just make the experience frustrating and unsatisfying no matter how much or little you eat.
- Extra protein even a protein powder, egg
- Complex carbs like beans
- No added sugar
- No processed food
- Intranasal insulin (diy - i am not diabetic)
It's tautologically true but doesn't help anybody.
But it’s more complicated than that. Especially when you bring homeostasis into it, where the body will adjust calorific expenditure downwards in response to sustained reduced calorific intake, as just a single example.
But there’s lots of things going on that influence the calories coming in, the calories stored and the calories expended. It’s unfair to reduce it down so far.
It leads to fat shaming by people whom have never struggled with their weight who justify their cruelty by parroting “calories in calories out”.
Even worse, some of those will do silly experiments where they put on weight really really fast and then lose it just as fast, totally ignoring the fact that their body has been in the original state for a long time.
Is it? In my experience the people who parrot that are people who were fat and through a combination of diet and exercise returned to a healthy weight.
I do agree though there's more to weight loss than just CICO(maybe insulin). Peter attia had a recent interesting episode on obesity and nutritional science.
There are also other ways to modify those two parameters that don't involve food and exercise. Are you a type 1 diabetic and want to lose weight? Just under dose your insulin and the pounds will fly off. Want to lose weight but you aren't diabetic? Take a little DNP. Want to lose weight faster? Take a little more DNP. Just don't take too much or instead of losing weight you'll die of hyperthermia. Taking DNP or under dosing insulin are not things I would ever recommend anyone do but they are both examples of non food and activity related ways to affect calories out.
What other science would you like prevented to spare people's feelings?
Which part of my comment says I’d like science to spare people’s feelings?
Show me the science that justifies fat shaming and inappropriate behaviour.
Fat shaming somebody because “science” doesn’t make you any less of shit person. In fact, you can’t really use any science to excuse poor behaviour.
So I think we might be in violent agreement? Do you talk to your mother like that when you misunderstand her? Wow.
Would I run up to a morbidly fat person and shout "Calories in/Calories out"? No. Would I contradict an obese person who said "Calories In/Calories Out" was wrong? Yes.
What precisely do you mean by Calories in/Calories out? Do you mean the very basic observation that eating significantly more or less than you eat today will help increase or decrease your weight, all things being equal? This is clearly true, but doesn't explain why some people naturally overeat, while others naturally undereat, and why overeating has been significantly increasing all over the world.
Or do you mean that people gain a pound for every 3.5k Cal that they eat? Because these sorts of numbers are pure gunk - there is huge variance between individuals in terms of how much overeating will cause how much weight gain. The relationship is also highly non-linear.
No-one said monitoring and reducing your calories is easy, but it is simple.
Which part of my comment says that it’s wrong? It IS a simplified view and there ARE many more variables that influence the success of dietary change. And there are even more that influence the wider obesity problem. But that doesn’t mean I’m saying it’s wrong.
As you said, the sky is blue. Is that wrong? No. Is it simplified? Yes, sometimes it’s grey. Sometimes it’s a deep blue. Sometimes it’s pretty much black. But, generally speaking, yeah it’s blue.
Is CICO the solution to the obesity epidemic? No, because it’d have worked to reduce the epidemic by now. It’s clearly _not_ the only thing we need to solve the epidemic. There is a difference between the method to lose weight and the solution to the obesity epidemic. The latter has many more variables in play.
Next time you contradict an obese person who “says CICO is wrong”, make sure they’re actually saying it’s wrong.
I am, however, glad you wouldn’t run up to people and shout “calories in / calories out”. That‘s a relief.
You literally said it here.
If there is anything that people who want to lose weight should do, it's eat less. Skip the snack. Smaller portions. That's incredibly hard to do, of course, and easier said than done, but ultimately it is behind virtually all successful weight loss. What is behind an enormous number of failed weight loss attempts are waving that away and believing some specific macronutrient is really the cause, if you just subscribe to whatever the current trend is.
People get really upset about the calories reality.
And indeed if you compare caloric intake between say 1970 and 2010, there was a significant jump in the average diet. Grain products rose, but not nearly as much as fats and oils rose. People ate more and they got fatter. When excess accumulates over time, the increase doesn't have to be large. More calories in, BMI increased.
And what about non-humans? Animals are getting fatter, too . Some of this can be explained by humans eating more, hence making more food available to those animals that eat human leftovers or steal human food. But this weight gain has also been noted in laboratory animals which are on controlled diets.
"People in the 2000's weighed about 10% more than people in the '80s who ate the same amount of calories, with the same micronutrient distribution, and did the same amount of exercise "
To say that the cited study is laughable gives it far too much credit. For instance it specifically and only considers leisure activities. As to self-described dietary results, the only takeaway is that people are far more full of shit now than then. It is Ginny in the Sopranos boasting about their diet while eating chocolate bars in the laundry room.
It's interesting how gullible people who are otherwise so discerning are when it comes to diet, particularly for dietary excuses. There is no field that has been so rife with study that upsets study, and gross scientific malpractice, as nutrition. But hey, here's one study where they mangled numbers from sets decades apart and drew some viral result. Serious groan.
However, when your parents constantly ask you if you want to eat, it's a bitch to resists the temptation.
I had lost 20 lbs without needing to keep track of how much food I eat, as opposed to how many meals I eat.
Anyway, I doubt reduction of calories is how you're going to keep your desired weight. CICO in the long term is a failure. Partly, because our model is actually wrong. Exercise is basically useless for reducing calories, because it's both very hard to do a lot of it, and your basal metabolism adjusts in the long run by adjusting itself to be lower. You should still do exercise, and if you can around 750 minutes per week, which is when you start hitting diminishing return.
People at a healthy weight consume less calories. Caloric intake has a perfect correlation with obesity. The psychological element is hugely difficult, but the science of "if you eat more you're going to be heavier" is very firm.
The Japanese eat, on average, 25% less calories than Americans. They have an obesity rate of 4% versus 36% in the US. This despite eating loads of "bad" calories like simple carbs (white processed rice).
The word 'psychological' is doing a lot of heavy lifting here. We have no reason to believe it is more or less likely for overeating to be caused by psychological rather than metabolic or other systemic reasons.
The fact of the matter remains that some people struggle with their weight while others don't. CICO doesn't address this at all.
Of course, CICO also doesn't work very well when comparing between people, despite your claim. For example, people with endocrin disorders are well known to lose or gain weight disproportionately in relation to their diets. Base metabolic rates vary significantly between people, even healthy ones. There are other discrepancies as well, which mean that, knowing person A and person B eat the same amount of calories and exercise the same amount will not help you to predict the weight gain/loss difference between them.
We are biological machines, and the amount we eat is biologically determined by our bodies (assuming food is widely available). We can somewhat influence that with rational thought, but to a limited degree, just like we can choose to breathe in faster or slower, but we can't maintain that for any length of time.
If it is endocrine instead, we would be looking for a drug to fix it, or a specific pollutant that could be removed. No one will tell you 'hey, it's your thyroid, just make it go a little faster'.
It's like having a thermostat that adjust the temperature to 70 degrees, and you want it to be 75. So your solution is to bring in more heat while ignoring the thermostat. The thermostat adjust by engaging the air conditioner. Which certainly will work, but also very inefficient.
Your body isn't that stupid and it's not certainly a dumb engine.
But hard exercise is hard! Folks don't want to do it. They want to stretch and walk around a track and pretend. But they don't want to do 20 miles on a bike. They convince themselves that they can't. Or they try and get aches and pains and decide that's bad. Pretty much throwing up roadblocks right and left, anything to avoid the work.
We all know this. It's why there are 1000 books about tricks and diets and how to fool yourself. Because we want to do that instead. But we can stop enabling that; stop making excuses for small issues about body adjustments and so on.
Most people are busy, they have jobs or families or kids. Yet decades ago, these same people aren't fat.
There's certainly no magic trick, but being dogmatic or smug isn't helpful either.
Smugness is nowhere in sight. More like resignation and sadness.
Why, of all things, do you think forcing people to do hard exercise would be effective for the vast majority of people, compared to, say, an improved diet?
The mirage of 'an improved diet' is the current fad idea and the topic of this conversation. Why doesn't it work for most people? Why are there 1000 books about it, and still no consensus?
> The basic metabolic rate varies between individuals. One study of 150 adults representative of the population in Scotland reported basal metabolic rates from as low as 1027 kcal per day (4301 kJ/day) to as high as 2499 kcal/day (10455 kJ/day); with a mean BMR of 1500 kcal/day (6279 kJ/day). Statistically, the researchers calculated that 62.3% of this variation was explained by differences in fat free mass. Other factors explaining the variation included fat mass (6.7%), age (1.7%), and experimental error including within-subject difference (2%). The rest of the variation (26.7%) was unexplained. This remaining difference was not explained by sex nor by differing tissue size of highly energetic organs such as the brain.
So this study  claims ~25% difference in BMR that is NOT explained by sex, weight, height, lean body mass etc. That can mean some people can eat an extra burger a day compared to others without gaining more weight.
It's also important to note that BMR is not the only biological component here. Both CI and CO are biologically determined, they are not under 100% rational control. There are clear differences in people in terms of appetite/hunger reaction, and in terms of desire for physical activity, that we don't have a known explanation for (psychology? endocrinology? metabolic causes? gut biome? other?). This is, in fact, the biggest biologically determined component of obesity that is usually entirely ignored and blamed entirely on the individual's self-control.
It is uncontroversial that by reducing calories in one's diet that it will cause weight loss. The controversy is centered around weight control, whether an individual can keep the weight at a stable level over the long run. In that sense, all diet fails.
I would contend that how many calories a person eat is only a proximal cause of obesity, especially since CICO is actually an incorrect model of how our body work.
Several people as in how many out of those that failed. If the statistics tell us that 90% of people failed, then these diets or programs are still an utter failure. By saying it is some kind of moral failing or willpower means we decided to be lazy about investigating the cause of obesity.
Remember, the obesity epidemic is a modern phenomenon. There are countries around the world that are still relatively lean.
 put about 30lb on during the pandemic period that I'm working off again.
I lost about 30kg (105 -> 75) by eating less, excersing more, all in about the span of a year. I never stopped feeling hungry overall for this period, constantly had to fight the urge to eat more. In periods where high stress reduced my willpower, I started putting back weight. I've put on about 10kg back in the following 5 years, so on balance I'm still in pretty good shape, but the trend is clear.
The mystery is why I have this relationship with food, and why other people don't. Most thin people are not going to bed dreaming of tomorrow's meal.
I eagerly await the day science figures out how to stop my food cravings and delivers it in a form I can obtain easily.
Unfortunately, loads of people in this very thread are disputing it. This submission is based upon the bizarre hope that there's a mysterious external influence that's actually causing people to gain weight, and not the merely coincidental simultaneous rise in caloric intake.
The psychological element is complex and profoundly difficult. That is without question.
People in cushy office jobs eating as much calories as they want in 1900 are much less obese than similar people in 2000. How come? It's not that the 1900s office workers put in more effort or attention to limit their calorie consumption and burn more calories, it's entirely the other way around.
People in another culture eating a very sweet-heavy diet (and eating as much of it as they want) apparently consume much less calories than similar people in USA. How come?
The psychological element apparently wasn't as difficult some decades ago - people in 1960s who had as much food as they wanted, and the same kinds of tempting calorie-rich snacks available, were much less obese not because they were better at overcoming some psychological difficulties, but because apparently much fewer of them had such difficulties to overcome. How come?
It would be valid to reduce weight gain to "How to eat as much calories as you should instead of as much calories as you intuitively want" if and only if wanting to eat much more calories than you should is some innate, natural thing. The article points out that the spread of this tendency is a novel thing, it used to be rare, and perhaps it can be made rare again, so it's worth investigating the cause of that unhealthy appetite miscalibration instead of having people fight through the symptom (which they're failing at, because it's hard).
If someone's organism was working properly, they should not need to pay attention to CICO as the body will balance both "CI" and "CO" to get a decent non-obese result - the experience of earlier times and other cultures shows that the human body almost always (96% of non-obesity) does that naturally. If now the same mechanism is failing for 40% of the population instead of 4%, that is not caused by a change in ignoring CICO, people were ignoring CICO hundred years ago as well.
I believe that the problem is not that different from the problem of alcoholism. Everyone lives in a society soaked with alcohol, some people do not feel an urge to drink at all, some people manage to keep their consumption in healthy limits for 50 years, some end up as hopeless wretches in 10 years.
The fact that you can force yourself to eat less than you feel the need to and lose weight in the process does not prove, as you seem to think, that weight gain is simply explained by people being weak willed and eating burgers instead of salad. You still have to ask why this change actually occurred, since it seems that it has occurred in the general US population about 50 years ago and most of the world has been following suit.
But there are massive industries that exist to tell people that no, it's really that you aren't eating enough food that is red. Or that fell to the ground. Or whatever. Whatever magical, simple fix means that they can still eat an excess of calories. These diets have a failure rate approaching 100%. The US is the most diet focused country in planetary history, yet also one of the fattest.
Maybe pretending that the basic thermodynamics are just some unachievable mirage is a really profoundly stupid approach?
And yes, people who have actually lost weight (or, more often than not, not gain it in the first place) simply ate less (it's magnitudes harder to burn more calories to any meaningful amount). Virtually universally.
But this makes obese people angry. It always makes them angry.
 - And authors. This paper cites Stephen Guyenet casually dismissing "CICO". The guy makes his living pitching easy "AHA" moments to fat people. It is, ironically, his bread and butter.
But lets assume it all boils down to calories in/calories out, your solution is singularly focused on calories in (eating less), that in a vacuum has no effect of calories out except generally a negative effect (your body will adapt and try to burn less calories). Thus, you are ignoring that the form of calories in directly effects the calories out, and that there are better ways to balance the equation by increasing calories out without necessarily reducing calories in, or in some cases increasing calories out might even require a caloric surplus (such as muscle building).
"that in a vacuum has no effect of calories out except generally a negative effect (your body will adapt and try to burn less calories)"
This is comically overstated. No, your body doesn't magically become super efficient. This is, again, feel good pablum to make people feel better about their situation, sure it is an unwinnable battle without Magic Product or System ("buy my new book and subscribe to my It's Everyone Else's Fault newsletter!"). But the feel good stuff clearly is astonishingly ineffective. This tact hasn't worked.
Find any person who is overweight but claims they starve themselves and log and count calories. In 100% of cases you will find a calorie excess, likely significant. Find someone who is a healthy weight but claims they "eat anything they want". In 100% of cases -- okay 99.9% maybe they have a big tapeworm -- they will have a lower caloric intake.
The latter is someone who likely skips meals. They don't snack. They don't drink giant sugary drinks. And then when it's pizza day they have four slices and all of the high BMI sorts lament how they wish they had such a "high metabolism" and that they can "eat anything". It's all bullshit.
There is a significant, very difficult psychological component to eating in excess. It is a very hard problem. But I'll take every angry downvote by people who seriously want to refute the core, fundamental truth about calories, likely while parroting nonsensical myth.
I take great issue with you saying 'they claim to starve themselves'. The entire point is that people who are obese can feel that they are starving while eating twice the calories that they should. Some other people feel full after eating half the calories that they should. This is the almost the entire problem, the unexplained difference.
And, despite your claim, there are also demonstrable differences in the base metabolic rate between people. One of the most basic is the difference between men and women, which is usually estimated to be about 25% — men are generally accepted to have to eat about 2500 Cal per day to keep their weight, while women should only eat about 2000 Cal (for example, by the NHS ). There is no reason to think that, if there can be a 25% difference in the BMR between men and women, there can't be similar differences between individuals as well. Of course, you won't find anyone who eats 10k Cal and is not gaining weight (outside professional athletes, perhaps), or anyone who is eating 100 Cal and not losing weight. But it's quite plausible for someone to eat two extra pizza slices and still lose weight compared to someone else.
I'm being pretty overt that when people make that claim they are often being dishonest. They know they are eating too much. There are psychological issues underlying this, but if someone tells you how little they eat yet they're gaining weight, they're likely lying.
> And, despite your claim, there are also demonstrable differences in the base metabolic rate between people.
Nowhere did I contest this. Men have more muscle mass than women and are generally larger. But between people otherwise equal, claims about varying metabolisms are largely bullshit. It is magnitudes less of an influence than it is held as.
I've been cited as a "fast metabolism" examples many times in my life. I skip meals constantly, can manage to go through a movie without eating a bucket of butter-soaked popcorn and a jug of coke, etc. I eschew all of those things. Then there's a bbq and I eat two burgers and the upper BMI people all gather around to tell the tale about how easy it is for me, what with my "fast metabolism". It's horseshit. It's destructive, self-enabling nonsense.
Another guy mentioned that when his belt size starts getting tight he knows it's time to cut back. Precisely my tactic. There have been a few times where suddenly slacks are a little tight and it isn't a signal that I need to buy new clothes or go to the next rung, but instead means it's time that I skip the occasional snack.
The fact that they are overeating doesn't mean that they aren't also feeling very hungry, truthfully. And again, neither you nor I know if it's a psychological issue or metabolic or endocrine or anything else (or a combination).
These are the two key facts that the article is discussing and you are completely ignoring in favor of feeling superior about your self control ("I can go through a movie without eating a bucket of butter-filled popcorn").
I think you're the one with the misconception. Obesity is consistently a contributor to health problems. Losing weight is definitely healthier for anyone who is obese and the way you lose weight is to eat less. Period. Full stop.
There are strategies for eating less that may or may not be more effective for most people, but it when it gets right down to it anyone telling you that you don't have to eat less is a snakeoil salesman.
What if someone eats the same but creates the caloric deficit through increased exercise? Will they lose weight?
Just like OP you want to simplify things as calories in/calories out while entirely ignoring calories out.
Losing weight is not healthy in and of itself, even in obese people, however, losing weight can be a byproduct of making healthy dietary and lifestyle changes.
Calories is just a unit of measurement of metabolic energy, that energy comes in 3 forms fat (ketones), glucose, and alcohol and is metabolized into energy (adp), but that energy production (metabolism) is more a measurement of health than a measurement of the total number of calories in. That is what you are ignoring.
Edit: I’m sure you have lost your weight through eating less. But have you changed and improved the actual foods you consume also? Have you begun to burn more through improved dietary metabolism and/or increased exercise? I have a hard time believing one day you were eating nutritionally deficient and caloric dense foods and lost 150 by making no other changes than simply eating less of the same calorically dense and nutritionally deficient food. Even more unlikely would be you being obese eating low calories nutritionally dense foods, and lost 150lbs reducing the calories.
Yes, but there's a reason for the saying "you can't outrun a bad diet". I get it though, you're technically correct and that's the best kind according to meme science.
> I’m sure you have lost your weight through eating less. But have you changed and improved the actual foods you consume also?
Yes, because that's one of the things that makes it easier. Some foods are more satiating than others. And yes, I did increase in exercise. In fact, the exercise preceded the weight loss because the activity I took up (rock climbing) was what finally provided enough motivation for me to overcome my desire to eat more.
> I have a hard time believing one day you were eating nutritionally deficient and caloric dense foods and lost 150 by making no other changes than simply eating less of the same calorically dense and nutritionally deficient food.
It's harder, but definitely possible: http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/....
My point being, you can add all the exercise you want but if you're not paying attention to your caloric intake then chances are you're just going to eat more to make up for the expended calories.
However the basic reality is that it's a lot easier/achievable to significantly change calories in. Simple keeping your body and brain operating is actually a pretty energy expensive function, such that dramatically increasing your activity is only going to mildly increase your daily energy use.
You can not eat that muffin....or exercise on the stair climber for an hour, for instance. As an aside, loads of exercise equipment and guides effectively lie about this by including basal calories with active calories, grossly overstating the calories "burned" by activities.
So again, exercise. Eat healthy. But most importantly of all, eat less.
Only for fat people. People like me find it fairly easy.
Over my adult life[currently 75yo], my weight has fluctuated modestly year to year (as measured by the tightness of my belt). When my abdominal circumference has grown by a couple belt notches, I tend to eat less for a while, until the belt is less tight. THIS REQUIRES ALMOST NO WILLPOWER OR CONSCIOUS ATTENTION ON MY PART. Why????
I think the real question raised by this article is why eating at the level required to maintain a specific body weight is second nature to some and torture to others. 'Calories in calories out' starts to sound a lot like 'if you don't want to be addicted don't do drugs'. It's much easier said than done by someone who doesn't understand addiction. In fact it's almost worse than addiction, as someone hooked on heroin or booze can do rehab or some other form where you just can't get ahold of those. But if you're addicted to food, you have to deal with the subject of your addiction 3 meal times a day (plus advertising!). That's a hard place to be.
Loads of people took in that information and never became addicted (at least until the medical industry tricked them into addiction). The information "if you don't want to be addicted don't do the thing that is sure to get you addicted" is very good advice. It is irrefutable advice.
Once you're addicted it's an entirely different, much more difficult problem. But it isn't a better understanding of addiction to say "Whoa, look I used heroin at a bunch of parties and now I crave heroin, therefore you shouldn't tell people to not do drugs". It doesn't follow.
a) Humans are spectacularly efficient at turning solar energy into bioavailable calories. This impacts virtually every animal.
b) Lab and zoo diets have dramatically changed. For instance in the lab there was a change from specific portioned diets to the notion that food should always be provided. Any study that claims that there was some mysterious rise in obesity is simply lying. And again there is a push for controlled, restricted diets because having sedentary rats and mice who can eat whenever they want is yielding unhealthy subjects.
c) The study this article links was lead by a guy who is an advisor to Coca-cola, Kraft, Frito-Lay, the Restaurant Association, among others. It is a profoundly corrupt industry, and yeah the notion that some mysterious unknown cause is to blame is convenient in that situation.
It seems like the decrease in satiety has a stronger effect.
Haven't people gotten a little less gullible about this stuff yet?
Look, some tribe had fruit on the ground and they weren't obese. Stuff that pizza is your mouth while we get to the bottom of this.
The reality is that calories have never been as available and cheap. And there is an absolutely lock-step correlation between dietary calories and obesity rates. No, it isn't the great mystery that it is held as. Indeed, this article spends most of its time debunking "it isn't the calories" dietary trends -- low fat, low carb, low sugar, low fat.
Don't forget addictive. We've become incredibly good at making food that makes you want to keep eating more of it. Once you pop, you can't stop.
But that is not what anyone I've heard is saying.
At least I think of "calories in / calories out" is a an attempt to defend against people believing in miracle diets or that they "cannot" lose weight.
All of that glosses over a million details, like how full you'll be feeling after 1000 cal from salad vs 1000 cal from Coke, but that's a whole another can of worms.
If you’re serious about losing fat, it’s essential helps to track the calories you eat, calories you burn, macro nutrient split (carbs, fats, proteins) and your weight.
- Calculate your TDEE (Total daily energy expenditure, also known as `maintenance calories`) There are many online calculators to do this
- Calculate your daily calorie intake to lose weight (Subtract 15-20% from your `maintenance calories`)
- Decide on a rough macro nutrient split (40% protein, 40% carb, 20% fat is a good place to start)
- Track the calories you eat and burn. There are apps for this that make it very easy (myfitnesspal is one example)
- Weigh yourself regularly and record it (Daily is better, first thing in the morning, without clothes and after any restroom activity)
- If you’re not losing weight, increase your daily exercise or reduce your calories by a further 5% until you see your weight going down
- Note: A healthy weight loss strategy is to aim to lose 1-2 lbs per week
You can absolutely loose fat without doing any of this but it’s 100x harder and will take much longer.
- Saving more than 500 calories per day is very hard, thus you are likely to only loose 1 lb per week/10 days of body fat.
- You need the will power to stay on course and fight off the hunger sensation. This is the hardest of any diet.
I don't believe that people can change their diet mix / macro nutrient split because there isn't enough choice to change your diet fundamentally without becoming bored quickly or being unhealthy or eco-unfriendly (for instance eating more meat).
I tracked my calories, and stuck to the daily allowance it recommended. I lost nearly all the weight by the agreed timeline (I lost 14.9kg in the end).
Think of it this way ... if you were thrown in prison today and they gave you only essential nutrients to survive, you'd lose a lot of weight. Your body might go into starvation mode first and try to fight against it, but without any calories coming in, you will lose weight 100% of the time.
I decided after years of wanting to lose weight, but doing nothing about it, I would just give up and do 1,000 calorie max / day for 3 months.
I lost 20 pounds to bring my BMI in-range without any other changes, and I'm middle aged.
That's not the healthiest way to go about this, but it does work.
Source: lost >150lbs and kept it off until the pandemic where I gained about 30 of it back. Stress is a bitch.
In which a man loses 27lbs on a diet of twinkies and was even healthier overall according to all metrics.
Between this and personal experience I'm prepared to say that as far as weight loss is concerned it really doesn't matter. Granted, different foods may have an effect on mood, energy level, and satiety which will all contribute to the CO part of the CICO equation, but all other variables kept constant a calorie is a calorie.
Much weight loss advice is equivalent to saying "spending money in cash is fine, credit cards are what make you poor", which actually may contain a grain of truth but kind of obscures the actual mechanism.
It also was a nice perspective to have in mind for me. Calories in, calories out means it doesn't really matter what I do today, it's what I do each day that matters.
Some types of meals are easier than others, though - e.g. if you make a large pot of "non-uniform" soup for the whole family for multiple meals, then it's going to be an estimate. It's socially inappropriate to do it at some situations (e.g. if you're visiting your grandma who's providing a meal), but on most days you should be able to track how much calories you got on that single day.
Some restaurants will provide numbers for their dishes, some won't. For takeaway/home orders weighing gives a good estimate - if you don't have the numbers for some kebab or sushi or pizza, then you can assume that it's going to be the same per unit of weight as someone else's similar product, what matters is how much of double cheese pepperoni pizza you eat, not the particular pizza maker.
For home-cooked I would do rough estimation based on weight and some quick web searches for calorie content of the ingredients.
After a short while I got a pretty decent hang of where the calories were, so could focus more on those. I had a small kitchen weight for the "heavy hitters", for the rest I just estimated based on listed weight and how much I used (~1/3 of package fex).
In the beginning I did weigh slices of bread and so on, and quickly built up a good overview over how many calories there were in such recurring items. Except for oils, butter and similar I wouldn't be super-accurate.
But having a fairly good idea of how many calories was in my food really helped me plan portion sizes and compositions to roughly match the deficit I wanted, as determined by a web page estimating my calorie requirement.
Like I said, focusing purely on calories in, calories out, rather than say "yes foods" and "no foods", made it a lot easier for me as I could eat what I wanted, just perhaps not as much.
For example, I quickly found out that my weekend favorite of steak with french fries and bearnaise was way over target. However, I found that if I ensured my steak was no more than 250g, swapped french fries for quality green peas and reduced the butter in the sauce by half, the calories were around my target value. So I could still enjoy my weekend treat.
One potential issue was to feel full while reducing portion sizes. For that I leaned on some studies I read about which seemed to suggest high protein and high fiber. So I tried to have at least 20% of my calories in proteins, and also have as much fiber as possible. My breakfast bread is 90+% whole grain, my pasta is whole grain, I swapped out iceberg lettuce for romain lettuce (which has much more fiber) etc.
Based on this I had a almost entirely linear decrease in weight over a year, without feeling like I was on a diet. In the end I lost 30kg.
I think something that is often neglected is: What portion of the calories you eat is used, what portion is stored, and what portion is discarded? It seems there is an adjusting screw that makes us store more of the consumed calories than before. If we just eat less calories total, we also gain less (sure), but we often won't have enough power to go around.
I can't find the source anymore, but I read a theory about high fructose corn sugar, or glucose-fructose sirup. Many debunkers say there is no problem with glucose-fructose sirup over sucrose (plain sugar), since sucrose is just split in the body into glucose and fructose, so it's the same. But the theory went that the body regulates sugar intake by regulating the breakdown of sucrose. If it is already broken down, there is nothing stopping the cells from taking all the simple sugars and using them.
I don't know if there is any merit to that idea - it doesn't matter, it's just the pattern of the argument I find interesting - that you have to understand the metabolic pathways and what the body does with the nutrients, rather than just count calories.
> Determining whether or not fiber calories should “count” depends on context and requires some background. Calories are a basic unit of energy that measure, among other things, how much burning power they provide to the body. Fats, proteins, carbohydrates and alcohol provide the body with energy or calories. The traditional estimates are that 1 gram of fat provides 9 calories, each gram of either proteins and carbohydrates provide 4 calories, and a gram of alcohol provides 7 calories. However, this doesn’t account for differences in how well food is digested and the nutrients available to the body. Poorly digested foods may not release as much energy for the body to use. This is particularly important in the case of fibers.
> Dietary fibers are complex carbohydrates, so some people estimate that they provide 4 calories per gram just like any other carbohydrate. However, others say that calories from fiber don’t count since your body’s digestive enzymes can’t break down fiber. However, fibers differ in how well they are digested or how much energy is available to the body. Some fibers, called soluble fibers, either absorb water and become gels or dissolve in water and reach the intestine where they are digested by bacteria. As they are digested by bacteria, soluble fibers produce short-chain fatty acids (SCFAs) that provide your body energy. The US Food and Drug Administration (FDA) estimates that fibers fermented by bacteria provide about 2 calories per gram of fiber. Insoluble fibers travel to the intestine with very little change. Instead of being digested, insoluble fibers increase bulk, soften stool, and shorten transit time through the gastro-intestinal tract. Because these fibers are not digested at all, the FDA estimates that insoluble fibers do not contribute any calories.
Actually many programs for social welfare are exactly based on the idea that it is more complicated than that.
The proponents of universal basic incomes for example have been fighting tooth and nail to even get this "tautological" fact accepted, and it is only now taking hold. The consequences of that would be that "simply" giving people money makes them less poor. It sounds simple when put like that, but it is a real struggle to have the conclusions of that be put into policy.
> [Next Time: A CHEMICAL HUNGER]
That's the part I really wanted to see. I've now bookmarked it so I can read the next instalment. I expect to hear some fascinating theories -- perhaps some modern equivalent of lead poisoning of ancient Rome.
Maybe it's survivorship bias? Without modern medicine only healthiest people survive to adulthood so later they live long healthy lives. In modern society these people would be healthy too, but they would be a small percentage of the whole society.
This would also explain why domesticated animals show similar problems. Because we keep them alive :/
And then since it's at least partially inheritable - the effect would compound with each generation. With unsettling implications.
We have ideas. Polyunsaturated fats (shortening, margarine, soybean oil, canola oil, even chicken fat) is a promising culprit. Consumption of those have skyrocketed in the last half of the 20th century . Full study here .
It seems that polyunsaturated fats induce hibernation like symptoms, which could explain weight gain. This blog is a fascinating look at some of the literature . Good summary post .
How does that square up with the lower prevalence of obesity there?
I think it's much easier to consume large portions of soybean oil if you're using it as an all purpose oil, than if you were just eating tofu, bean curd, natto, etc.
There may be a generational effect at play, causing the symptoms to be more pronounced in the offspring of the high margarine cohort. Certain interventions effect second and third generation offspring. You can induce sterility in the third generation by an intervention in the first generation for example.
That being said, canola oils and soybean oil are more used than ever.
As an obese person who tried several times to follow medical advise, this does not surprise me, not at all!
Every diet is about calories and sport, which cannot hurt. But every diet completely misses the elephant in the room: hunger!
Any medical procedure is only worth pursuing if it gives you a higher quality of life in the long term. A constant hunger cannot compensate for any weight loss.
And this is why a new drug just approved in the US for obesity is hailed as a game changed, NovoNordisk's semaglutide. (Wegovy) The "only" thing it does is mange the hunger levels in your body so you dont feel hungry all the time.
I think there was a study back in February for it which gave something like a 15% weight loss after a year, *on average*.
I did a sweet potato diet for a month a couple of years ago for medical reasons.
I was never hungry.
Switching cardio for resistance training (5x5) helped immensely with no changes in diet. My weight has dropped slightly, but my body composition changed a lot. Cardio became much easier after building some muscle mass.
There is also something addictive to increasing the weight you can lift, fits right in with gamer/nerd mentality.
Swimming also seems very effective, though I've not checked whether that effect's outside what's expected, or just normal.
As long as you're consciously making that trade off. Hunger vs shorter life, health conditions etc. I think that's a personal choice for the individual.
Estrogen, cortisol and testosterone all operate in a delicate, interrelated balance, so it's not too big a leap.
Take a simple model with a combination of all the factors the author discusses (type of diet, sugar, trans-fats, caloric intake, processed foods, exercise, genetics etc), allow interaction between the factors, and have the lipostat as the dependent variable. I.e. several factors together will, over time, upregulate the lipostat.
A relatively simple model that evades the authors objections, yet might fit the data.
I've sometimes wondered if microbiome factors are in play, and by extension, things like antibiotic use (maybe there are some studies about antibiotic exposure and weight gain?). I've usually thought of it in terms of microbiome -> gut -> digestion though, and the lipostat section made me wonder if it's more like microbiome -> "immune response" -> caloric expenditure.
This study was being discussed quite a bit when it came out, although there was prior work on it:
One hypothesis is that there's been a decline in baseline immune activity with decreased exposure to pathogens, better sanitation, better treatment of infections, etc. But people don't know for sure.
I'm not sure that it applies to the obesity crisis as temps have been declining over a longer time period than what seems to be involved in that. But it got me wondering if there's something like that that might have came into play later. My guess is no, that it's something else, but I could see how antibiotic use might somehow be involved.
It's how fast those calories get into bloodstream as a glucose.
"Fast" carbohydrates are extremally efficient in this regard; you can eat a ton before hunger leaves you. And this is a big gotcha as we constantly overeat being fooled by our mind and carbohydrates with high glycemic index.
So, it is not just calories: it's the amount and speed of insulin response to those calories.
Then again, it woildn't totally surprise me if it were something like indoor lighting or something.
Edit: The second article accounts for some combinatiins but not to my satisfaction. Also:
> The USDA Economic Research Service estimates that calorie intake in the US increased from 2,016 calories per day in 1970 to about 2,390 calories per day in 2014. Neither of these are jaw-dropping increases.
That does seem like a jaw-dropping increase if sustained over time and other varianles are held constant. So, huh?
I have another idea though since it talks about lipostat theory: Isn't it known that cortisol exposure causes weight gain? What if it's simply that our life is morr stressful despite being objectively less chaloenging in some sense. This could be due to anything from less cardio to a bad news diet.
Possible the worldwide most known modern food product is the Big Mac. Named Big Mac, not Best Mac, think about it.
And it doesn't stop there, large pizzas, pizzas with a lot on top, XXL Schnitzels, All you can eat Chinese.
A lot people make quantity a priority over quality, guess what happens :)
By the authors examples eating 1.000 calories extra for 10 days gives you 1kg of weight gain. Assuming that the average diet went from 2.000 to 2.400 calories, it makes sense that people should gain 400*365/10.000 = 15kg per year until that extra body mass is increasing base level energy need or people are more physically active (but 1 hour of physical exercise is only 600 calories for many sports).
Hear, hear. I dropped ~70 pounds just by learning my portions. It took about 6 months, but now I can just look at a plate of food and separate out the amount that will fill me, before I even start to eat (the 2-fist rule is a good start). I can make 2-3 meals out of a typical restaurant dinner portion, or I can just order an appetizer as my meal if I'm not taking leftovers.
I dropped another ~20 pounds by cutting out processed foods, preservatives, and chemicals. I likely won't eat something that I couldn't otherwise make a home using whole ingredients.
Restrictive diets never worked for me. I eat whatever I want, whether it be loaded with carbs or fried. I just make sure to include plenty of fiber in my diet, only eat when hungry, and never over eat. It's the only diet that I've been able to sustain for more than a year (~5 years now, to be exact).
This is an interesting comment someone left ... it's one of the only ones that could potentially explain all of the results, outside of some outliers like the altitude effect.
> With these premises it seems almost obvious to attribute the obesity pandemic to an external factor – for instance, virus or bacteria. My money is on gut bacteria being altered by some bacteria/virus, of which transmission is relatively hard (but it persists), which spread like wildfire in the last forty years and which thrives on cafeteria diets (which would explain its emergence in the second half of the 20th century).
A 20% increase in food intake seems huge. The data I could find on weight over the same period puts people at only 15% heavier, so this seems to be underselling the difference.
Now take several of these "insignificant" factors, add interaction effects, and we potentially get a much richer picture.
When the time of insulin comes (approx. 2 hours after food intake), the insulin curve is sharp and overshoots over the peak in response to monstrous amounts of glucose in the blood. Despite clearly peaking, no amount of insulin can cover all previously consumed glucose at this stage, and the rest of it gets transformed into the fat.
Stressing yourself out and triggering that "horror"-phase (movies/ evening news) makes your body go into the "binge" for reserves during crisis mode.
End of the World screaming makes you fat, Continuous bored calm and mental safety feelings make you thin.
I just left this comment in the site (maybe it would interest somebody here too):
"Have somebody checked a correlation between breast feeding vs. infant formula in early infancy and hungry feelings in adulthood (or weight as a proxy of that)?
It’s just an random idea, but it seems to me that the timeline of increasing obesity and increasing of use of infant formula could be correlated."
> (...) I think at this point, few people in the research world believe the CICO model.
It is popular on HN too, as evidenced by the replies I got here:
Simple self experiment: If you are super hungry, try compare:
1. Eat a bowl of plain steamed rice (in hot water can make it go down easier) - you will very very quickly become satiated and stay that way, probably on less than a small bowl.
2. Eat cake, croissants, stuff that is sweet but not too sweet that you can keep eating it... initially you will stop, but then you will feel hungry again and keep going back for more - you can just keep eating on this stuff, even though the energy density is way higher.
The other difference is the speed at which the energy is released, the rice will keep you going through the day, your body gradually extracting energy from it... the cake and stuff get's absorbed almost instantly and so your body has nothing to do but make fat with it - the only way your getting that energy back is through ketosis, which wont happen so long as you keep eating cake.
It makes a lot of sense when you start to think about how things have been modified from their natural state, even orange juice is kinda bad in this sense - you can drink a glass of orange juice pretty easily, but there is no way you will be able to eat the number of oranges it took to make it in a single day.
For all but our most very recent ancestors, periods of chronic hunger was just a missed crop or bad harvesting season away and mass starvation was only slightly more distant. Famines were common in most of the world and often killed many millions per year, almost every year during millennia, of all ages, including children and infants. Obesity-caused deaths are still deaths but at least they tend far more towards killing later in life and are much more in the hands of any given individual to avoid, as opposed to starving because your whole region no longer has enough food to keep you living regardless of your dietary choices.
Generations of people prior to all but the last century or so of history would be amazed, and possibly even envious at how abuntantly and cheaply most of the population can feed itself today, even to the point of chronic obesity.
Elevated cortisol level induces over-eating; moreover, increases craving for high-sugar, high-fat foods.
The big change in human behavior in the last 2 decades is that now people consume more information that leads to depression, anxiety and stress.
This popped in my mind since everything seemed to go off the rails with an abrupt change in obesity in the mid 70s…
Many (most?) of these plots have known, and different explanations - e.g. the wage stagnation at the top is due to public policy changes in the 70s; the rise in marriage age is probably due to birth control becoming prevalent in the 60s, but it is really interesting to see all the effects gathered in one place of the repercussions in the past 50+ years from all the societal and political changes that happened in the 60s and 70s.
So from that point of view, yeah, it would be great if at least some people switched to plant based substitutes instead.
Now obviously the problem is that we possibly have the science to make these substitutes so delicious, people will overeat them and in the process make themselves worse than had they just had meat. That is also a concern, absoluteley.
The person who will invent low-calorie bread and cheese, she'll be the Messiah :-)
Isn't it important to distinguish the type of sugar?
I thought the 5-10% increase in proportion of sucrose to fructose was sufficient enough to result in significant difference between how types of sugar impact insulin response. E.g., the shift to more easily-metabolized fructose results in even more available calories to convert to fat than the 50/50 sucrose/fructose found in fruits.
> even when statistically adjusting for variables like age, BMI, and physical activity.
I find this hard to believe, that the statistics were adjusted correctly for physical activity. You can talk about !Kung, Maasi, and Inuits all day long, but these tribes are wildly active compared to the typical desk-jockey westerner. That can't be shrugged off so easily.
Take for instance this Nick's brand ice cream. It's 7 net carbs per pint and texture and flavor is pretty much identical to 'real' ice creams out there.
Franz makes a wonderful 0 net carb bread (and hamburger and hotdog buns now which are honestly just as good as the regular cheap buns).
Not saying companies need to strive to be 0 carb, that's crazy. If they just stopped putting 50g of sugar in everything that alone would go a long way. Ps: Allulose/Psicose is amazing.
Cost has got to be one of the biggest factors, but I'd also say the overwhelming majority of people still have "fat is bad" firmly ingrained into them - it's going to take a very long time to diminish that.
And of course, people like sweet things.
This focuses more on ingredients, which is relatively common knowledge. But it does go into some history with interesting backstories from board rooms to flesh it out: "NYT: The Extraordinary Science of Addictive Junk Food" - https://archive.is/DJ0fC
This one I find super fascinating. It focuses less on ingredients and more on the physical forces/sensations of the foods: sound, crunchiness, meltiness, airiness, and how those drive compulsion to grab another handful: "Food cravings engineered by industry" https://www.cbc.ca/news/health/food-cravings-engineered-by-i...
But prob also true.
Think something like 'HFCS', or 'remove all the fiber', etc.
If you put enough power/money/ideology behind something, people will believe it, or not question it, etc. Probably, they/we, won't even be able to 'see' it.
Like where I live now every other street corner has those "mix-your-own candy bag" shops, where you pay by the 100g. There must be someone buying that stuff, since they keep popping up.
This doesn't seem to match the data: https://www.businessinsider.com/americans-are-drinking-less-...
I've heard this being claimed a lot, and have therefore often thought about it while eating fast- and other processed foods, picking around in it trying to discover the big conspiracy, but I can't seem to find any substantial differences with what I make at home from raw ingredients.
The engineering seems to be geared more towards reproducibility of all the dishes over a large network of franchises around the world. It's still the same ingredients, they're just less tolerant of substitutions and deviations from the specs.
Maybe it's really a matter of fast food being compared to food cooked by unskilled home cooks who just happen to be suffering from a socially induced panic about some arbitrary ingredient, and therefore tends to produce a result that's just plain unpalatable compared to something made by a professional or a seasoned home cook.
No cook with any amount of self respect will make intentionally unpalatable food, and the French paradox clearly demonstrates that it's not necessary for food to be unpalatable to avoid obesity.
He basically exposes the underlying physiological mechanisms of fasting and nutrition. And puts it in context of our biological evolution and current first-world diseases. Explains the enormous power fasting has for healing the physiology, regulating insulin levels, even reverting insulin resistance, how when you stop eating for a day the body activates the expression of certain genes in every cell for producing all the antioxidants known to man, promote autofagie of dead cells, producing growth hormones, start growing bone marrow cells, stem cells... How insulin is a key piece in that mechanism, how in western societies are junkies of processed food, specially sugar, carbohidrates and, and how by eating too often and too much we keep our insulin leves always high, which impedes our body to begin that innate process of self-healing we have, and we instead just saturate the body with things it doesn't really need and don't give it the opportunity to get rid of them, deriving in preventable diseases.
He speaks about 24h, 36h, 3day and 7 day fasting... How it affects multiple things, including response to chemoterapy, diabetes, dementia...
He has a previous talk called "The bittersweet truth" where he dives more deeply on how exactly fructose basically poisons the body and talks more about insulin, fructose, nutritional myths... Just one fascinating fact after another, supported by data, studies and clinical experience. He tryes to relate the facts in order to give you a very powerful big picture.
This is the lipid hypothesis, which still drives nutrition advice and laws today.
Ansal Keys joined the board of The American Heart Association which adopted the lipid hypothesis and started telling everyone to cut out fat and eat more carbohydrates (carbs are sugars strung together which are quickly chopped up and metabolised as sugar, what could go wrong? ;). Numerous clinical trials, involving tens of thousands of people, all failed to find a link between fat and heart disease (often actually finding the opposite). The government ignored these trials and supported Ansal Keys instead.
The Mcgovern senate committee was tasked with creating a national nutritional policy in 1977, but when scientists told the commission that there was no evidence supporting the low fat/high carb diet and that more research was needed to confirm the hypothesis, they where told that the government does not have the luxury of waiting for scientific research  and in 1980 the USDA published the dietary pyramid that we still use today, recommending that people get the bulk of their calories from carbs.
The single epidemiological study by Keys was all they had to go on at that time. Since then, there have been many more rigorous diet trials which failed to confirm the lipid hypothesis and actually show a strong link between carb consumption and obesity. So the scientists introduced an entirely new scientific method, now called teleoanalysis to prop up the lipid hypothesis. No causative link between dietary fat and heart disease could be found in controlled trials. But, they did find an association between fat and cholesterol, and then they found an association between high cholesterol and heart disease. So now using teleonalysis we can say that fat is associated with high cholesterol and high cholesterol is associated with heart disease therefore fat causes heart disease.
The American government officially supports the lipid hypothesis and promotes the high carb diet pyramid at all contact points. Schools, universities, government agencies all must promote the lipid hypothesis or be sacked or defunded; "The dietary dogma was a money-maker for segments of the food industry, a fund raiser for the Heart Association and busy work for thousands of fat chemists... To be a dissenter is to be unfunded because the peer-review system rewards conformity and excludes criticism"
Carbs have low nutritional content and most vitamins are fat soluble so by eating less fat you feel more hungry because your body needs those nutrients and you are forced to eat more. When you eat a lot of carbs, your liver gives you an insulin shot. Insulin tells your fat cells to absorb the carbs to bring the body back to balance. So your fat cells swell and then divide, making your body bigger, and a bigger body requires more food to sustain it.
The result is that obesity and heart disease have increased about 10x since 1980 
Book: Pure, White, and Deadly
> A Tanzanian hunter-gatherer society called the Hadza get about 15 percent of their calories from honey. Combined with all the sugar they get from eating fruit, they end up eating about the same amount of sugar as Americans do. Despite this, the Hadza do not exhibit obesity.
that eats unprocessed sugar? including that found in fruits??
Part II is equally interesting.
> We can further cite the fact that many cultures, such as the Hadza of Tanzania, the Mbuti of the Congo, and the Kuna of Panama all eat diets relatively high in sugar (sometimes as high at 80%), and yet none of these cultures have noticeable rates of obesity, diabetes, cardiovascular disease, etc.
i'm all for looking at populations of folks and then looking at the effects of their new diets -- whether they moved to the food, or the food moved to them -- but i don't even see the beginnings of an apples-to-apples comparison here.
to me, a layman, i don't see Nutrasweet and sugar and honey and cookies and apples to be all the same in terms of the effects of their 'sugars' on the body.
i must be missing something.
is it that the author is The Smahtest Guy To Evah Live?
or....i mean, s/he has a long list of Nobel Prizes in Physiology?
or maybe just some long history of unbelievably incredibly insightful comments/writing/literature/research on this or any other topic?
i figure i've read and listened to at least dozens but probably hundreds of articles, books, youtubes, etc. over the past few years, and i'm not convinced i have the answer, but one blog post citing one tribe and you're all in? seems strange to me.
i suspect a plurality of folks would say that there are multiple contributing factors to obesity, something like:
- sugar (in particular, highly processed sugar in all its forms/delivery mechanisms),
- highly processed foods generally (don't send 'full' signals to the brain, lack of fiber, etc.),
- modern lifestyle/quick eating/lack of exercise, cheap sugary/processed/fatty foods, etc.
Then argue against the factual evidence it cites, not against some silly strawman.