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Comment by amasad | Hacker News Reader

This is demonstrably false. No respectable scientist believes in the calories-in-calories-out model of obesity anymore.

It isn't that no one believes in that model of obestity any more. If you locked people in a cage and gave them 1,000 calories of snickers bars a day, yeah they would get lean.

But what complicates the situation is that what you eat affects how much you crave food, and what foods you crave, and how much energy you have, and how you sleep, etc.

Sugar seems to be bad on all of these ancillary fronts.

Well, yeah, exactly. Saying that "consuming fewer calories than you expend leads to weight loss" is obviously true, but it's a little like saying "you win a game of football by scoring more points than your opponent." While it isn't wrong it doesn't tell you that much about how to go about it.

Not the OP, but for all the people commenting below, I think what the OP means to say is that the body is a very complex system and calories from different sources absolutely do have different affects, on your ability to control fat storage and fat burning and to modulate your appetite. The laws of thermodynamics still hold - if you overeat it doesn't matter what you're eating, you will gain weight. But calories in calories out is so simplistic by comparison to reality, that it's a harmful way to look at things.

It is the Newtonian physics of nutrition. It is demonstrably wrong, yet following the rule will lead to success for just about every real life use case.

Go eat 5000 calories a day of veggies without becoming obese then. Just because calories isn't the only important factor in obesity does not mean its not a factor at all. Scientists are simply building a more sophisticated understanding of obesity that looks at many other factors.

I think the post you’re responding to is referring to well established results such as that there is no metabolic pathway to convert dietary protein to adipose tissue. While some dietary protein is glycolysized, that pathway only satisfies immediate energy needs. Excess dietary protein that isn’t used on lean tissue is eliminated by the kidneys.

Thats interesting.. so does that mean eating a lot of protein cannot make you gain fat? It would just be a tax on your kidneys instead?

Well in practice it would be very tough to over eat on protein alone. Assuming a 2000 calorie diet you'd need to eat over 500g of protein which is roughly 4lbs of chicken breast or 5lbs of tuna.

But at that point it would also be quite harmful to the kidneys

Unless you’re Dwayne Johnson.

Seriously though if you don’t have kidney disease then you really don’t have to worry about protein consumption.

Eating 5000 calories of veggies is impossible. That's like 25kg of tomatoes or 35kg of lettuce. You can't eat that in a day.

I think it may be difficult to eat that much just eating vegetables.

Several people have asked for sources, so I'd like to point those people to this article, which is an easy-to-digest overview:

http://www.latimes.com/opinion/op-ed/la-oe-teicholz-calorie-...

It starts with "Since the early 1900s, medical research has shown that people do lose weight on calorie-restricted diets — in the short term. But in most cases, they quickly gain it back..." and goes onto the studies on things that actually do work long-term, like fixing your sleep, fixing your stress, and limiting carbohydrates in your diet.

>But in most cases, they quickly gain it back.

So they gain it back once they stop being on calorie-restricted diets? This isn't a surprise to anyone. The point of any of these things, CICO or otherwise, is that you do them for your lifetime as a lifestyle change.

We have a century of evidence that calorie restriction is not a diet people can stay on. I just sourced this above. Calorie restriction alone while eating fast food, soda, cake, etc is a diet of chronic hunger/deprivation, and "become a monk with an iron will until your death" is not a reasonable "lifestyle change" to suggest. That's why "just count calories" is not the advice any respectable scientist would give an obese person, which I believe was @amasad's point.

But to sustain a weight loss you basically do have to eat less, forever. I say this being 60 pounds below my highest weight (200 vs 260).

Someone is talking about protein conversion, but I expect it is just harder to eat excess calories of meat. The 2 pounds of beef a day it would take many people to maintain body weight is a lot of beef to sit and eat.

I have mixed feelings about this line of argument. Both sides are technically correct.

- If you burn more calories than you take in you will lose weight no matter what the source of those calories are.

- psychological, what you eat will make it easier to maintain a calorie balance and that varies based on the individual.

For me, I ate like crap from the time I was 25-35 but maintained a healthy weight and a decent physique as a part time fitness instructor who worked out 12 times a week.

I like working out so it doesn’t take discipline to work out and my wife will work out with me occasionally but she prefers going to the gym and taking classes.

I stopped working out consistently for five years and my weight ballooned.

I then tried to eat better but I couldn’t get the level of discipline necessary to lose weight.

Then we moved into a house, I converted a room into a home gym and started exercising for 2 hours a day 3-4 times a week that burned about 1500 calories per workout. I got back down to my fitness instructor weight and size in 7 months. I also had to make it point not to eat more to compensate, and only “cheat” on the weekend.

All that being said, when I was teaching and even now I tell people that they can’t exercise thier way to weight loss. Most people don’t have the stamina, the discipline, or the time to work out enough to burn 4000-5000 calories a week and maintain a calorie balance.

> We have a century of evidence that calorie restriction is not a diet people can stay on.

We do? Last I checked we had a century of people being told that fat is bad and they should eat the fat-free high-sugar yogurt. CICO is still a hotly debated concept in many circles. Such as this thread.

Calorie restriction doesn't tell you what you should or should not be eating. That is the beauty of it. It doesn't tell you what you do. It doesn't resign you to eating spinach for the rest of your life. It doesn't say you can never have ice cream.

> Calorie restriction alone while eating fast food, soda, cake, etc is a diet of chronic hunger/deprivation, and "become a monk with an iron will until your death"...

Is a strawman nobody suggested. Any diet that it seems you would prefer, that is more detailed/restrictive in its advice is nonetheless still a calorie restriction diet because nothing else would actually work.

Calorie restriction and counting is a request for introspection. If it gets you to simply realize that big macs are really calorie dense, and that you'd break your daily limit with 3 of them, it has done its job. It's up to you to figure out if you have enough willpower to still include big macs in your diet. Mostly overweight people just have no idea how much they're actually eating.

OK... that is news to me... do you have a link to a paper that proves this demonstrably false? Disproving a law of thermodynamics sounds like a big deal.

How does the new model explain people losing weight in adverse conditions?

I'm watching someone steadily lose weight via calories-in-calories-out model in front of me right now.

Obviously calories matter, but there's just so much more going on than that. For example, your body's shifting metabolism. Eating certain things causes this to shift. Some people eat healthy constantly and remain overweight; others can't put on pounds no matter what they take in. That's a difference in their natural metabolisms. This is also why exercise matters beyond just the calories you burn over the course of a workout.

> Obviously calories matter, but there's just so much more going on than that.

The purpose of black box perspective is to not worry about the "so much more going on". Regardless of what happens in the box the rules of energy must stay put. As for the human body, the science there is young, it's extremely complex, there's a lot of misinformation, a lot of it was grabbed by governments ("don't eat fat!") to ill effect. Let's not. Just take it easy with the portions.

Metabolism shifts are not that large. If you are following CICO, you're counting calories, and that is already an error prone process. There's not a big difference between "my metabolism shifted because of this odd food", "I drank some alcohol", and "I miscounted how much beans I actually had". It's fine, if you have a good enough weekly target and you stick to it, you will have a baseline. If you are not losing weight, reduce the target.

It will work. If you are saying it won't I want to see a straight up study that says it put 500 men on a 1500 cal/day diet and they didn't lose weight.

Note that I am only talking about the physical angle, not the sociological one. "Juice is not healthy" is, to me, a non-sociological claim, but a scientific one, and I would prefer that "x is unhealthy" means "x is mildly poisonous", not "x is calorie-dense", because there's nothing actually wrong with calorie-density.

Calories in - calories out. However, what goes out (urine, stool) depends on the type of nutrition and in what combination it is eaten. carbohydrates are the easiest to absorb, followed by fats and last protein.

I'd say accounting for hunger is also important since few people are going to be able to stick to a diet where they're hungry all the time.

Sure, though I think that’s already covered in the ‚calories in‘ part, it just shows that it‘s a non-linear system (which is generally hard to reason about outside of science & engineering contexts).

What do they believe in now? I still thought calorie-in/out was the truth. I'd love to see some articles.

It is way more complicated than that. The body autonomously regulates the amount of calories that you eat. For example when you exercise more studies show people will eat almost exactly an extra amount of food equalent to the calories exercised.

The average person gains an extra 1 to 2 pounds a year. It takes 6,000 calories to gains 2 pounds. This is about ~16.5 calories a day. About a fifth of a slice of bread.

This is an imbalance of energy, on a 2000 calorie diet, of less than 1%.

> It is way more complicated than that. The body autonomously regulates the amount of calories that you eat. For example when you exercise more studies show people will eat almost exactly an extra amount of food equalent to the calories exercised.

The whole point of something like calorie counting is so that this is no longer some automated, subconscious process.

Be wary anytime someone mentions "scientists" in their argument. More than likely OP has no source. Nevertheless, I get his point. Basically, calorie-in/out is still very much used but it doesn't tell the full story. At the end of the day you will gain weight if you eat too many Calories, but eating an apple will make you feel fuller than a chocolate bar, etc. Scientists dont even have a stake in this really it's more like nutritionists, and the jury is out as to whether we can call them scientists.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496172/ https://www.physiology.org/doi/abs/10.1152/ajpendo.00156.201...

I mean, this calories in calories out study is in the same NYT issue: "Exercise May Aid in Weight Loss. Provided You Do Enough." https://nyti.ms/2KMz7f9

Seems like it doesn’t matter what scientists say. People still go for stupid things like keto and other weird train wreck diets.

You're really going to have to clarify what you mean by "this." Overeating is healthy?

I'd think the part about "what particular foods you eat doesn't matter"

Huh, what do they believe to be true now?

Could you please do us the service of demonstrating that it is false? Overeating is unhealthy is demonstrably true.

These works seem to disagree with you.

Your turn. Please do try to disprove the law of conservation of energy.

Swinburn B, Sacks G, Ravussin E. Increased food energy supply is more than sufficient to explain the US epidemic of obesity . Am J Clin Nutr. (2009)

Lack of evidence for high fructose corn syrup as the cause of the obesity epidemic Leibel RL, et al. Energy intake required to maintain body weight is not affected by wide variation in diet composition . Am J Clin Nutr. (1992)

Golay A, et al. Similar weight loss with low- or high-carbohydrate diets . Am J Clin Nutr. (1996)

Golay A, et al. Weight-loss with low or high carbohydrate diet . Int J Obes Relat Metab Disord. (1996)

Luscombe-Marsh ND, et al. Carbohydrate-restricted diets high in either monounsaturated fat or protein are equally effective at promoting fat loss and improving blood lipids . Am J Clin Nutr. (2005)

Bray GA, et al. Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating: a randomized controlled trial . JAMA. (2012)

Noakes M, et al. Effect of an energy-restricted, high-protein, low-fat diet relative to a conventional high-carbohydrate, low-fat diet on weight loss, body composition, nutritional status, and markers of cardiovascular health in obese women . Am J Clin Nutr. (2005)

Keogh JB, et al. Long-term weight maintenance and cardiovascular risk factors are not different following weight loss on carbohydrate-restricted diets high in either monounsaturated fat or protein in obese hyperinsulinaemic men and women . Br J Nutr. (2007)

Farnsworth E, et al. Effect of a high-protein, energy-restricted diet on body composition, glycemic control, and lipid concentrations in overweight and obese hyperinsulinemic men and women . Am J Clin Nutr. (2003)

Brinkworth GD, et al. Long-term effects of a high-protein, low-carbohydrate diet on weight control and cardiovascular risk markers in obese hyperinsulinemic subjects . Int J Obes Relat Metab Disord. (2004)

McLaughlin T, et al. Effects of moderate variations in macronutrient composition on weight loss and reduction in cardiovascular disease risk in obese, insulin-resistant adults . Am J Clin Nutr. (2006)

Sargrad KR, et al. Effect of high protein vs high carbohydrate intake on insulin sensitivity, body weight, hemoglobin A1c, and blood pressure in patients with type 2 diabetes mellitus . J Am Diet Assoc. (2005)

Boden G, et al. Effect of a low-carbohydrate diet on appetite, blood glucose levels, and insulin resistance in obese patients with type 2 diabetes . Ann Intern Med. (2005)

Heilbronn LK, Noakes M, Clifton PM. Effect of energy restriction, weight loss, and diet composition on plasma lipids and glucose in patients with type 2 diabetes . Diabetes Care. (1999)

Parker B, et al. Effect of a high-protein, high-monounsaturated fat weight loss diet on glycemic control and lipid levels in type 2 diabetes . Diabetes Care. (2002)

Thomson RL, et al. The effect of a hypocaloric diet with and without exercise training on body composition, cardiometabolic risk profile, and reproductive function in overweight and obese women with polycystic ovary syndrome . J Clin Endocrinol Metab. (2008)

Strasser B, Spreitzer A, Haber P. Fat loss depends on energy deficit only, independently of the method for weight loss . Ann Nutr Metab. (2007)

Astrup A, Meinert Larsen T, Harper A. Atkins and other low-carbohydrate diets: hoax or an effective tool for weight loss . Lancet. (2004)

Golay A, et al. Similar weight loss with low-energy food combining or balanced diets . Int J Obes Relat Metab Disord. (2000)

Calories-in-Calories-out is a straight-up fact. The thing 'scientists' don't like about it is that even if you lose the same amount of weight, where you got your calories from will impact your health differently depending on whether it's a chocolate bar or an apple. Nevertheless, Calories-in-Calories-out is a true model.

> where you got your calories from will impact your health differently depending on whether it's a chocolate bar or an apple

Is there evidence that this is sufficiently impactful that it should be brought up? I.e., if a person is steadily losing weight, but eating not super healthy, should we tell them to stop?

Overweight people often already don't eat very nutritiously so I'm not sure if it's a large impact. Basically afraid of "perfect is the enemy of good" here. Obesity is a very dominating factor as far as unhealth goes, and many "unhealthy" foods are often marked so because they link back to obesity.

It's impactful enough to be brought up because it's far more important to develop healthy eating habits than it is to lose weight in the long run. If you asked me whether it's more unhealthy to be obese than to be normal weight but eating food with no nutrients, that is something I cannot answer with evidence, but I'm inclined to say eating 5 chocolate bars a day will kill you faster.

Very true. But don't make it the only factor in losing weight. You need to manage amount of food, what you eat and when you eat. They all are important.

Important in what sense?

Important in this context to me would mean: if I don't eat spinach, or if I skip breakfast, I will NOT lose weight on a calorie deficit. Is that what you mean by important what you eat and when you eat, or something else?

Let's assume you eat the same amounts. It makes a difference if you eat in the morning or in the evening. If you eat very late most likely you won't digest as well and you will gain weight.

You will always lose weight on a deficit but depending on when you eat the amount for a deficit will be different.

Same for the type of food. From my own observation I will gain weight if I eat only a few pretzels daily even if everything else is the same. I assume they cause my digestive system to lose efficiency.

Let's assume you eat the same amounts. It makes a difference if you eat in the morning or in the evening. If you eat very late most likely you won't digest as well and you will gain weight.

That’s considered a myth that’s been debunked ages ago.

https://www.webmd.com/diet/features/diet-truth-myth-eating-n...

The good thing is that with eating you can do a lot of self experimentation and see if things work. I have done this experiment myself and I know a lot of people who also have noticed that the time and frequency of eating makes a huge difference. In this case I trust personal experience more than some study. The health profession doesn't have a very good track record of helping people with weight control.

It’s not the time that you eat from what I’ve read. It ends up being a form of calorie restriction by reducing the number of hours that you eat.

If I come home, work out and then it’s late and I’m hungry,I’ll often just go to bed and not eat. It’s much easier dealing with hunger when you’re sleep than skipping breakfast and then trying to concentrate at work. It’s also, by definition, easier to resist temptation when you’re sleep....

And you sleep better on an empty stomach once you are used to it.

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