Many of them are simply not counting their calories in correctly. There studies out there that people are, in general, terrible at counting calories and underestimate them.
Some of these disorders will over a long period of time cause a person to expend fewer calories than someone of equivalent body weight and age. This is likely due to gradual changes in body composition or activity. Maybe even small variations in body temperature (I need to look into this one a little more).
In most cases, the reason for the weight gain is a combination of both of these things.
The laws of thermodynamics are not in question here. The issue is that the prescription “eat less calories” is sort of like I said to you “I want to achieve more during the day; what do?” and you said “just start sleeping two hours a night”. I can do that for a while. It will appear to be “working”. There’s no particular night I can point to and say “this is the night where it’s impossible to sleep two hours”, I can seemingly always do it for one more night. We don’t even really understand what sleep does, so the limits on my capacity to not do it are not obvious. It’s always possible to accuse me of simply not trying hard enough. Nonetheless, in the long run your suggested solution is unendurable, I will simply run out of the capacity to do that, and while it appeared to work in the short term, in the long term it likely made my productivity problems worse.
In the case of calorie restriction for weight loss it’s a matter of debate how much of its ineffectiveness is down to metabolic countermeasures employed by the body and how much is compliance issues, but it’s a distinction without a difference. In either case the body runs out of the capacity to maintain a calorie deficit. “Hey you maintained a calorie deficit for a day, that means you can do it indefinitely” is no different to “you slept for only two hours last night, that means you can keep doing it forever”. It’s just ignorance of the difficulties involved in defying what your body demands in the long term.
But calorie restriction does not work in the long term as a weight loss tool, so educating people on it is beside the point. Again, this is like the distinction between “sleeping less hours a night allows more waking hours in which to accomplish things”, which is just a fact, and the jump to “therefore if one wishes to accomplish more in the long term one should sleep two hours a night every night” which for a whole host of complex reasons doesn’t follow.
I’m going to quote again from this paper which is from a leading researcher in the field, here is the opening sentence of the paper, which is not cited because it is so thoroughly established:
Prior research has demonstrated that dieting, or the restriction of caloric intake, does not lead to long-term weight loss.
Your belief that caloric restriction does lead to long term weight loss seems like a religious one. What I mean by this is that given the thermodynamic fact of CICO, it’s not obvious to me what empirical evidence I could possibly present to you, even in theory, which would cause you to abandon this belief.
You’re claiming I’m saying things I’ve never said. I don’t know if you are confusing me with someone else or doing it on purpose. I’d give you the benefit of the doubt, but I did post the following directly in response to you earlier.
I hadn’t remembered this was you but I was even going to use your posts above as evidence that these accusations that I was caricaturing the beliefs of CICO advocates were wrong. When Lawnmower_Man asked why you thought people with endocrine disorders were obese, this was your first port of call:
How am I supposed to read this other than as a claim that caloric restriction works for long term weight loss? Why would you suggest people improve at counting calories if you don’t think this works?
The question was “Why do you think these people are gaining weight?” My response was that one reason is that they were taking in more calories than they thought they were.
That’s how you were supposed to read it.
Now your turn: How do you propose someone have a long term weight loss without taking in fewer calories than they expend for a period of time.
Also, interestingly, if you look at the very study you posted, they noticed this:
“The restricting groups lost significantly more weight (mean weight loss of 1.9 pounds) than the groups who did not restrict (mean weight gain of 2.6 pounds)”
It sounds to me like the restricting probably just stops working when they stop restricting. And yes, compliance is a huge problem, that doesn’t change the mechanics of the calories in/calories out energy balance.
In that sentence there, the implication is that one possible prescription for preventing the tree from falling would be stopping it from rotting. But if I take your sentence “one reason is that they were taking in more calories than they thought they were” and I say “oh, so you’re saying that if they kept a more careful eye on their calorie intake they would not be obese”, then you say “no that’s not what I’m saying”. Well how the fuck is it a “reason” they’re obese then? When Lawnmower_Man asks “people with endocrine disorders are obese because _____”, the blank should be filled by something which, if remedied, would lead to them not being obese anymore. Otherwise you’re not answering the question.
I’m not proposing that. I’m saying that this is equivalent to asking “how do you propose to win a game of sportsball without scoring more points than the opponent”. Of course that’s what has to be done, since that’s just a restatement of what it is to win a game of sportsball. When I say that CICO doesn’t work for weight loss, I’m not saying the concept of weight loss can’t be expressed in thermodynamic terms. I’m saying that expressing it that way is not helpful for getting at the reasons why people find it hard to lose weight. You keep claiming to understand this yet when asked why people are obese, it’s immediately “they’re taking in more calories than they think”. It’s very confusing.
I’m not saying bolded what I’m saying is slightly different: If they are able to maintain a caloric deficit for a period of time they will lose weight.
Just because they “keep a more careful eye on their intake” doesn’t necessarily translate into results. If they go from being really terrible to just terrible, they have become more careful, but they won’t lose weight.
I’m ignoring the second part of the equation here (i.e., calories out) for simplicity, but it’s certainly theoretically possible for effects their to outweigh effects on the intake side.
I was thinking of making a similar comparison myself.
I’d agree that my position is identical to saying “to win you need to score more points than opponent”. And that’s all I’m saying. Nothing more.
What I’m definitely not saying is that it would be good coaching. If the coach said to the team, “OK guys, you just have to score more points than the opponent” or “You have to try hard to score more points than the opponent”, that would be bad coaching.
But the fact that it is bad coaching, doesn’t make the statement false. It will always be true that you need to score more points than the opponent to win.
This would only be true if you thought caloric restriction was the only way to lose weight. If you have an endocrine disorder, treating that would be a great start. I have lost 10kg on two occasions by the simple expedient of coming off the SSRI I was on. Even where the answer is diet it’s better to concentrate on what one eats rather than counting calories.
I think the problem with this is that the definition of “calories in” and “calories out” is so flexible as to be meaningless. For example in the cannabis users study I posted upthread, the authors proposed that cannabis use undoes the deleterious metabolic effects of a low omega-3 diet. The way you fit that in is to say that either cannabis use leads to less Calories In because energy is just excreted rather than used, or maybe more Calories Out because the body’s metabolism is accelerated by cannabis use. I think it’s supposed to be the latter but I’m honestly not sure. What I’m also not sure about is what clarity this sort of sophistry adds to the analysis. There’s no limit to what you can fit in to a CICO model if you squint hard enough. If it turned out aliens were harvesting ATP molecules from people’s bodies to power spaceships you’d be like “yea dude well that’s still Calories Out, BOOM, First Law of Thermodynamics wins again!”. It just seems meaningless.
When you say weight loss is the same as CICO, the implication is the more natural ideas about calories in (i.e. the food we eat) and calories out (i.e. our activity). Since it’s not even remotely true that weight loss amounts to food in vs activity out, this is misleading.
You keep mentioning endocrine disorders. What percentage of obese people have one of those? Are those the people we should be focused on? Just because there are people who have complicating factors doesn’t mean any method that doesn’t work for them has to be thrown out.
We might have to use a modified approach for some groups of people. The basic principle still stands. As long as one’s CI>CO one will gain weight.
An enormous percentage of obese people have genetic, epigenetic and physiological factors contributing to their obesity. This seems like that thing again where addicts are excused from not having “willpower” because they have “a disease”, while the rest of us supposedly stand ready to deploy limitless amounts of willpower if we try hard enough. People don’t either have a condition which contributes to obesity or not, there’s a sliding scale.
I think one thing that probably needs clarifying is that a lot of fat people are fat simply because they consume too many calories. There are a lot of guys, me included, who would drop a few kg if they never drank a beer again. But for people who are trying, really trying, to lose weight and finding it very difficult, “insufficient attention to caloric deficit” is the proximate cause in very few.
If there is an underlying condition that slows the metabolism to the point where restricting calories plus exercise becomes impossible. Not quite sure what you are getting at. Let’s say we have a case where CICO for whatever reason is not feasible. What is your strategy then? Is it treat the underlying condition and then do CICO?
BTW it’s quite insulting that you compare the shorthand CICO to a religious belief.
I think the main problem here is that you are choosing to express your position in a really weird way. You say stuff like “CICO doesn’t work”, but later when asked how is it that someone loses weigh, you readily admit that it is because they consumed more calories than they took in. Now that’s really confusing.
What it seems like you are trying to say is that merely telling someone to “eat fewer calories than they consume” and nothing more is not advice that most people can convert in to a sustainable result. And that is a reasonable position. I get that it’s more words to type it all out like that, but it makes things much clearer.
Reducing it to “CICO doesn’t work” makes it seem like you are rejecting some really basic scientific principles. Believe it or not, there are people who actually don’t believe the basic thermodynamic principle of CICO. So getting you confused with one of those people is not that hard, especially if someone is not willing to read walls of text.
This is why I go to the diseases that cause obesity: to see if you have enough awareness to pivot off your belief. The stronger aspect is that I’ve chosen a disease of metabolism. If Metabolism was a Broadway musical, Cortisol would be one of the main characters. That’s probably why some of the top obesity researchers like Traci Mann are studying its effects. It’s not like cortisol is an evildoer that invades the sovereign nation of Metabolistan–cortisol is metabolism. It’s one of the main catabolic actors in the anabolic/catabolic set of reactions known as metabolism. So what’s happening in these people is a remodeling of their metabolic architecture, and your explanation for their obesity is
Many of them are simply not counting their calories in correctly. There studies out there that people are, in general, terrible at counting calories and underestimate them.
that people who are maintaining a normal weight suddenly become bad at estimating calorie intake when we wreck their metabolism. Cortisol, among the many things it does, breaks stuff down (like proteins) and mobilizes glucose. In excess, it causes a specific phenotype in humans: muscle wasting in the extremities and lipodystrophy with fat accumulation in the abdomen, head, and neck. I don’t care how much willpower you have and how little you eat; if I pump you full of prednisone, it will recomp you from lean muscle to visceral fat. The degree to which that happens will depend on things like if you’re over/under expressed in certain enzymes in the pathway, i.e., “genetics.” Again, this isn’t CICO. You could fast for all I care. The reasons for this are complicated and not completely understood but you can start with lipoprotein lipase (LPL) upregulation and 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) expression in visceral fat if you want to start down the rabbit hole:
I know that you already know this, but we should clarify that by gaining weight we mean gaining fat. If I loaded you with anabolic steroids instead of catabolic steroids you might gain a ton of lean mass and become Mr. Universe on the same diet and exercise program but wouldn’t complain about weight gain. The only people I can imagine complaining would be ones that became too muscular or something.
So it’s not clear to me what you’re claiming about the people with these diseases and their inability to count calories accurately. First of all, the diseases are all different. Hypothyroidism is like underclocking a CPU whereas hypercortisolism is like deleting and storing stuff in memory improperly. People don’t randomly guess how much to eat like Victor thinks. That would only make sense to someone who doesn’t know anything about the physiology of hunger and satiety in humans (and other animals). In some diseases, e.g., Prader-Willi syndrome, congenital leptin deficiency, and leptin receptor deficiency, the cause of obesity is overeating (macrophagia) due to the hunger/satiety feedback loop being broken. Rats know exactly how many calories to eat without spreadsheets unless you you knock out the LepR gene or enzymes in the JAK-STAT pathway, then quickly eat themselves into morbid obesity.
Perhaps the best test is a natural experiment where a person who is objectively great at both the feeding and the exercise parts gets their metabolism wrecked by disease. Here’s one data point:
So if we follow the Random Cakewalk theory, maybe she was just randomly guessing the correct number of calories to eat as a competition fitness model the whole time and her luck finally ran out.
Some of these disorders will over a long period of time cause a person to expend fewer calories than someone of equivalent body weight and age. This is likely due to gradual changes in body composition or activity. Maybe even small variations in body temperature (I need to look into this one a little more).
We can check that too:
Vicki Perez first noticed she was gaining weight back in October 2015 – and in less than 12 months she had ballooned from [130 lbs] to [172 lbs].
That’s 42 lbs gained in one year by a competition bikini fitness model. Nothing about her change in appearance strikes me as gradual. How anyone could look at the before and after pics of this lady and think she has anything other than a serious illness blows my mind.
Despite numerous tests, medics continued to deny there was anything wrong.
Do you see a pattern here? The case I posted about upthread, the lady in the videos I posted upthread, and this fitness model were all told they were healthy by doctors who assumed they simply didn’t know how many calories they were eating. I can post dozens if not hundreds of these cases. It’s the norm for people with this particular disease out of the many that affect hormones and metabolism. It’s why I try to help people get to the right doctors. So it doesn’t matter if you personally believe CICO is only a useless tautology about the laws of thermodynamics. In practice, at the contact points where it actually matters, we have doctors telling people that if they were locked in a closet with only water they’d lose weight. These are the extreme cases where we have diagnostic tests and scientific literature to back it up. Now imagine how it goes for the milder cases (ideopathic obesity) where we don’t.
Come on. You’re only quoting one of the two reasons I gave and the next paragraph that follows is covered by my second reason.
If the Cortisol changes your body composition, then your metabolism will go down, which means your caloric expenditure will go down. Or as I said in the part of the post you seemed to ignore:
EDIT: Ok now that I finished the text wall it seems that you acknowledge it at the end. Seems a little out of place, but I’m not sure why you seemed to ignore it in the part of the post that it was relevant.
