I'll be interested to see where the scientific consensus is in 10 years. I think the evidence is very much on the side of the hormonal theory of obesity and fasting, especially given the monumental failure of the "calories in calories out" model.
Can you explain this in more detail? CICO seems like it might oversimplify things but it always seemed like a really sane basis for helping shape your diet. If you need to lose weight, you should plan meals to create a calorie deficit. But yes, I would not be surprised to learn that fasting on day X and consuming double your normal calories on day X+1 are not equivalent.
The description of CICO as a "monumental failure" sounds like there's substantial evidence to the contrary -- can you share more info?
I was once well north of the weight of the subject in the article and have since shed about half of it and kept it off for years. I've been through all the games your brain and body play to try and get you to eat more, and all the fad diets out there sound to me exactly like those games. It's nice to believe you don't have to suffer to reach your goals, but it isn't true and anyone telling you otherwise is trying to sell you something.
The role of hormones (especially insulin) in regulating fat storage and whether stored fat is available to the body as energy is better understood now, and much has been documented about how high insulin combined with low calories over time results in a lowering of the metabolic rate (resulting in stalling weight loss and then weight gain) rather than sustainable weight loss.
Also "it's nice to believe you don't have to suffer to reach your goals" is a silly and moralistic thing to say. But it typifies the american "scientific understanding" of weight loss. Fat is immoral, suffering is virtue, therefore in order to lose your immoral fat you must suffer.
Just look at all the massive success of those in the IF and keto community in living joyful lives, not deprived, losing fat etc. etc. And then look at all the people for whom calorie counting has completely failed. The information is out there (shruggie)
Well, it's not just some fixed calorie amount they need to take for an eternity. It's the amount that corresponds to their current weight and muscle mass. As those change over time (and their base metabolic rate changes), they should change their calorie target too.
>Also "it's nice to believe you don't have to suffer to reach your goals" is a silly and moralistic thing to say. But it typifies the american "scientific understanding" of weight loss. Fat is immoral, suffering is virtue, therefore in order to lose your immoral fat you must suffer.
Actually the 'silver bullet' is more typical of the american "understanding" of weight loss.
There's no silver bullet. No pain, no (weight) loss.
If it promises you to lose weight without limiting your calorie intake (e.g. have your weight loss cake and eat it too), then yes.
>but "use our magic equations based on state of the art info from 1958 to calculate your daily food needs and all your food and exercise as numbers and if your equation balances you'll lose weight" isn't
The laws of thermodynamics don't change because we don't have good formulas to calculate the exact amount of calories a person has a basic metabolic rate just based on their weight and height...
Calories still matter, and you should still limit your intake -- whether you do it approximately by "state of the art info from 1958" or with modern medical tests and expensive equipment. Or you know, just with eating less that you normally do, even without counting calories (if you ate 1 steak per day, and you change it to 1/2 a steak, you're eating half as much calories, even if you don't know how many exactly). Skipping BS deserts will cut even more...
No great science required, millions of people have lost way by just eating less...
If you're already very fit and lean, but have some stubborn fat around the "love handle" area or elsewhere, "eat less" doesn't cut it any more. Sure you can reduce that area, but not completely, and while the rest of you turns into an ugly skeleton.
The latter people are then delluded, surgery aside, you can't lose targeted fat from a specific body area. You lose fat across your body AND from that area, or you don't lose fat.
At best, you can trait that area and build some muscle next to the fat.
I'm not convinced most of those evangelists have actually lost and kept off significant amounts of weight, and nearly everything they say reads like a sales pitch so I'm not inclined to trust it.
> Also "it's nice to believe you don't have to suffer to reach your goals" is a silly and moralistic thing to say. But it typifies the american "scientific understanding" of weight loss.
Saying you can achieve your goals with less effort if you BUY NOW is even more american. Even if no one is asking you to actually pay money for a program, they're still shilling an idea.
Keto and fasting are fighting an up-hill battle: the only thing you can sell is guidance, and that is freely available. The keto bar/additive industry is minuscule.
In fact, the article says "He kept to low-fat, low-calorie food for three years. It simply didn’t work. At one point he lost about 10kg but his weight rebounded, though he still restricted his calories."
Keeping a diet like low-carb or low-fat etc (and other fads), is difficult, so many rebounce.
But the true lifestyle change of a balanced diet is difficult anyway too, and most can't do that either.
(And you do need a balanced diet, whether you follow the calories/in out or not).
This doesn't invalidate the calories in/out, just their ability to apply it (and it's not necessarily their fault, they can have all kinds of impediments causing them to overeat, eg. situational depression).
On the other hand, if you know 100% your calories, you can diet even with the most surprising foods:
http://edition.cnn.com/2010/HEALTH/11/08/twinkie.diet.profes...
It's hard to doubt that lowering your calories consumed will cause weight loss. However, it's not obvious that the physical mechanism behind weight loss in itself provides enough structure for people to use as a practical tool for weight loss.
It's like if someone is trying to pitch a faster baseball and their coach introduces them to the "conservation of momentum" strategy for throwing faster. The idea being that if you want to move the ball faster, you have to move your arm faster too. Well, duh, but it's not obvious whether this will help anybody. It might be the case that practical strategies for pitching faster never make reference to the principle of conservation of momentum. That doesn't mean that conservation of momentum doesn't ultimately explain why every different strategy works, but it doesn't make "conservation of momentum" a strategy all by itself.
"Eat high quality foods" may very well be a better strategy for losing weight than counting your calories. It might be easier and more healthy than calorie counting for most people. That doesn't mean that "calorie in/out" doesn't on some level explain why this strategy works (although, there might be good reason to doubt this in some cases, new research suggests that the interaction between gut bacteria and food are an important factor in how people respond to different diets). But the fact that "calorie in/out" explains weight loss doesn't mean that it needs to be the central concept in everybody's dieting decisions.
So, it obviously isn’t just “carbs time 4k/cal”. Ok, let’s assume we can tell which carbs are useful and which aren’t. It takes energy to extract that energy. How much? IIRC there is over 50% variation between people (and even same person at different time) of the amount of energy actually extracted - yet almost everyone uses 100year old Atwater factors as if they were a fundamental physical constant.
Glucose storage is supply based. But gluconeogenesis (conversion of protein to glycogen) is demand based, so you must be at a deficit for the 4kcal/gr protein measure to be used.
How about body temp? A person at 35.6C uses a few tens or hundred calories less per day than a standard 36.7C person. Yes, these exist. Did you take this into the CO equation?
Did you consider the liter of ice cold water you drank? Takes 37kcal to warm it up to body temp.
CICO as usually practiced has 20-30 margin of error, which makes it much less useful than people assume. Unsurprisingly, it does work for e.g. 70% of the people, who assume the rest are not properly counting.
I don't think that's the case at all - do we have examples where people, strictly observed didn't lose weight when eating under their caloric requirements?
There absolutely is a pile of mitigating factors in how someone eats or lives, but that's like saying "exercise has been proven to not help people run marathons" just because most people who try to run a marathon don't succeed.
Furthermore - on phone now, can’t find ref - but mass general IIRC had a study where people where being significantly over fed (with a feeding tube) yet lost weight; google Robert Israel and Michel Cabanac for more info.
CICO is an often useful approximate description - but it is not (other than tautologically useless) a law.
The fallacy is that those numbers are anything but a very vague approximation.
On the regular medical world, there are just new inputs about things that also matter, as science and our understanding progresses (as opposed "the calories thing is wrong, let's throw it out altogether").