What I learned losing 70 pounds: Medical interventions work, among other things
slowboring.com
slowboring.com
It’s basic Law of Thermodynamics.
Energy in = energy out.
And if you’re putting more energy into your body than you’re exerting out, it turns into extra weight.
It’s literally that simple, and take that from someone whose done every type of diet plan in existence.
Now yes, there’s food to eat that are very filling but lower in calories (like grilled chicken vs donut).
But it’s still not anything more novel that calorie counting.
On average weight gain is related to overeating for most people, but the reasons for overeating may be complex and varied, so makes saying calories in/calories out inaccurate.
It specifically points out that it's clear that this is how the medical interventions discussed in the article work: reducing calories by altering eating behavior.
Also the article: it isn't taboo to say "just eat less", just that it is as ineffective as telling people with compulsive alcoholic behaviors to "just drink less".
It’s more likely to be a function of people not knowing how many calories are in food.
Eg, a salad from Chick Fila A might sound healthy, but it’s actually 850 calories.
That’s nearly 1/2 of your daily intake.
https://www.chick-fil-a.com/menu/cobb-salad
It’s also the same reason why schools in the US removed soda machines because it was a contributing factor to child obesity.
I strongly doubt it. In the UK, they put the amount of calories pretty much everywhere and there is still a obesity problem.
Energy in = energy out
More likely, people are underestimating the calories they are consuming, or are cheating.
My father is obese, and has been for many years. At the weight he usually hovers at, his BMR appears to be ~2,500 calories. He can lose weight from here no problem eating ~1600 calories a day, not easy, but not to hard.
The problem is, that after about 15 lbs of weightloss, he plateaus. Dexafit scans confirm there's been a massive reduction in BMR. By the time he's dropped 20 lbs his calorie counts generally need to be in the 1200s to lose weight, which is just torturous. The longest he ever last at these really low calorie counts was probably a year, I'm significantly smaller fitter than he is and I could not have lived a productive life on the diet he was eating.
I'm not sure how common this kind of response is, but his doctor's didn't seem to think it uncommon.
So he is something like 60, sedentary, 5 foot 10 and 280 pounds. That results in a estimated TDEE (BMR plus accounting for calorie burn of basic life activities) of 2504 calories per day.[0]
> By the time he's dropped 20 lbs his calorie counts generally need to be in the 1200s to lose weight
In this scenario that would drop his TDEE to 2395 calories per day.
At 1200 calories a day, if those numbers are correct should see at least 2 pounds a week of weight loss. If he is maintaining, check your priors.
He is either overcounting exercise, over estimating TDEE or under counting what he eats. If you have weights and accurate calorie counts you can extrapolate his TDEE from that and know exactly what deficit to eat at.
This is what naive calculations say, this is not what a DEXA scan says. His body is actively reducing calorie expendature well below what you would expect.
I have tried taking over his calorie counting for a week to help him, as someone who manages my own weight successfully I don't think I would overcount by a factor of 2. The chance he ate calories I was unaware of during that week is approximately zero (highly controlled environment, never left apartment)
[0]https://www.uhcw.nhs.uk/leading-research/about-us/our-facili...
I eventually lost (and kept off for the last 6 years) all the weight I wanted by cycles of cutting and bulking. I'd slowly raise my calories, eventually settling at a slight 10% surplus for eight weeks. I'd then start tapering calories for eight weeks, eventually losing about 8 pounds of fat. I'd repeat the cycle, gaining about a quarter pound of muscle and 2 pounds of fat. Then repeat again.
Obviously this is a huge hassle, but I was able to go from obese to the lower end of healthy weight, and in the meantime got my deadlift to 2x my body weight.
Also so many veggies. Lunch and dinner, 2 cups of veggies before the main protein.
Now to keep it off, I still eat the veggies, and I also drink a ton of water before a meal. And lastly, our meals are pretty much just variations of lentils, legumes, and chickpeas. Those have good protein and fiber. We'll add olive oil for fat. Some pita, high fiber tortillas, or whole wheat bread adds carbs.
of course you can lose the weight by eating less, and also water is wet. the problem is that once you become fat, you have the appetite of a fat person. forever. of course you can diet and exercise your way back to a healthy weight, but you will be hungry forever. except for a exceptionally small percentage of outliers, humans cannot psychologically keep up that level of constant discomfort and discipline indefinitely when the solution is in the fridge just a few steps away.
imagine telling an heroin addict to "just do less heroin" when their house is full of heroin, people are constantly doing heroin around them, and they have no choice but to take small amounts of heroin three times a day or they die. except for a very small handful of people who are wired differently, it just isn't something you can reasonably expect a person to achieve.
It’s also the same reason why schools in the US removed soda machines because it was a contributing factor to child obesity.
if only that was the only place to buy soda
I'm not sure how you think it's taboo when it's been almost the only prong of our society's approach to obesity.
"Guys just eat less lol". And when it doesn't work it's "Man is it taboo to say it or something? Can someone find out if the fats are receiving the message?"
And when people find out society is trying other approaches to fight obesity like surgery or Ozempic, it's "Wait, have we tried the only thing that we've been trying for 100 years?"
But you can control what you eat.
But for the sake of argument let’s assume, as you claim, that calories in - calories out is all that matters. Especially if you make that assumption then “Just eat less” is a nonsensical piece of advice. Because “Just eat less” simply restates the problem, which is people eating too much.
Actually useful advice would require helping a person with how they can eat less, and helping resolve the issues that lead them to eating more than they should eat.
No doubt some people may have more efficient eg digestion of soluble fiber into SCFA based on their microbiota, but based on usual levels of consumption I would think this would make an absolutely trivial difference.
Sure, if everyone could count their calories with razor-sharp accuracy and eat less than they burn, everyone would be at the weight they want to be at, and nobody would need to look at pesky fat people anymore, right?
I mean, I've counted calories with MFP for the last 10 years, and I know my BMR and TDEE and all that. If I can do it, everyone can, right?
Except, ah, right, there's that one thing I forgot: not everyone is mentally wired to log everything they eat every day!
Some (many) people don't even need to log since they don't eat that much anyway (and don't want to).
Oh, and how I could forget? Some people are simply hungry ALL OF THE GOD DAMN TIME. Calorie counting doesn't make the hunger go away, either!
The one thing that many people taking GLP-1 agonists like Ozempic or Manjaro have said over and over is "I didn't know I could just not feel hungry." That is absolutely wild shit!
So, no, telling fat people that your body is a thermodynamic system (it is not, at least not a simple Thermo 101 style one) and CICO and MyFitnessPal is all you need isn't a solution.
A better one, IMO, is to understand and maybe empathize with the fact that every body is different and that an ideal weight means something different to everyone.
There's still stuff to work on, especially: realizing how many calories are in seemingly innocuous things, how A can lead to B, and prevent C (like buying junk food->can't not eat it if it's in the house->good food doesn't taste good), how certain foods trigger worse hunger rather than resolve it, etc.
Mathematically, it may resolve to "east less," but the mechanics are much more complicated.
Having made a trip to Italy very recently I can second this.
We ate huge amounts of food (not necessarily any huge meals…the slow Italian eating style made it difficult to eat too much at any one meal) but we were eating a lot of different things because there was so much food we wanted to try. And we drank a lot of wine. I don’t usually drink much but Inwas probably averaging a bottle of wine a day in Italy.
Ok returning to America after 10 days I hadn’t gained any weight and had even lost a little (although that was likely just natural variances).
American food (including possibly many fresh ingredients…many fruits, for example, have extremely high sugar contents bred into them) are simply not good for you.
Modern diet is not what we evolved to eat.
Until recently there was no agricolture, no bread, pasta, pizza or bakery. There was no basket of fruit readily available every day of the week (it was an occasional treat when in season).
I had to lose weight a few times in my life (10kg, not too much) and I always struggled and counted calories like a maniac.
The last time I was not only 10kg overweight but I had some severe stomach pain. After 2 years of struggling I tried the carnivore diet. In a week, all my stomach issues disappeared and I lost 8kg in a couple of months, without counting calories. If I eat animal fat I'm simply not hungry: I can't overeat.
Demonising fats and meats was the worst thing society did and definitely contributed to the overweight epidemics.
Most social media dietary discourse focuses on magic-trick memes instead of the basic principles. Twitter and HN acts like it’s the hamburger bun and some pasta alfredo making us fat and not the 4000 calories we eat per day altogether. How about eat less, move more, avoid calorie dense foods.
For example, eating out is 1000+ calories. Unless you curb one of your other three meals and don't snack, you're going over your 2300 calorie (or whatever) budget right there.
In January of this year, I went back on the program — time-restricted eating, counting calories, 10,000 steps per day, and a new exercise regime with super slow weightlifting.
That is a huge, rapid regain. Yup even with surgery he's back to having the same problems as before and having to be careful to avoid overeating. Hardly a miracle. It also shows how hard it is to fight obesity when even after taking such drastic measures as having surgery the weight comes back so fast.
The problem is surgery is just a temp fix. The stomach gradually expands again to accommodate food, and BMR/TDE falls a bit (metabolic adaptation is common after such procedures). Weight regain is very common 2+ years later ,so without fixing the underlying problem of food addiction/overeating, all or most of the weight will return even with surgery. The type of surgery he had has a higher risk of regain compared to to others. Surgery does not fix the tendency of the body to want to store extra calories, of formerly obese people to want to overeat. GLP-1 drugs help with this to a better extent.
I believe this is wrong in general. The following research, for example, shows at least one form of exercise likely reduces hunger:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3761859/
I suspect it depends on the kind of exercise.