The more there is research into how fat actually works as a tissue the more I suspect CICO is a harmful oversimplification along the lines of just say no to drugs or abstinence-only sex education.
People get burned when measuring the “out” part because our bodies want to hold on to as much energy as possible.
But yes. CICO is and always has been absolutely true. People are just overly reductive in how they measure both sides, and then claim that CICO is garbage.
It’s ok to assume that you absorb 100% of what you eat, unless you see evidence to the contrary, and no corn kernel poop doesn’t count. Frequent diarrhea, weight loss, skin rash, and basically any symptom of vitamin or mineral deficiency.
That's not really true. If you've ever done the keto diet, you know that your body expels unburned ketones through your breath, sweat, and urine. Protein can be used to repair structures rather than burned or stored for energy.
There's also something called the "thermic effect of feeding". Your body requires more energy to process protein (20-30% of calories consumed) than it does carbs (5-10%) than it does fats (0-3%).
In other words, "calories out".
> It’s ok to assume that you absorb 100% of what you eat
Your gut absorbed it. That is literally what digestive absorption is about. Expelling ketones is not digestive malabsorption.
I don't think it's unreasonable to think that different bodies absorb food in different ways (or proportions), particularly given what we've seen about the gut microbiome
Apparently even just changing the time of food intake can affect obesity (in rats) if this study is to be believed: https://pubmed.ncbi.nlm.nih.gov/22608008/
In response to, "but those are rats", I think it's a lot easier to cast doubt on "100% of food is always absorbed" vs "I don't think that always holds true"
I mean, heck: if there are no residual calories in human waste, how can it burn?
About the rat thing: the cico hypothesis point of view might look at whether meal timing affecting energy expenditure first, rather than assuming meal timing change digestive absorption.
There is not much point in getting in the weeds about how much you absorb, unless you're running trials on yourself like changing when you eat, or what you eat, and leaving all other things equal like calorie intake and expenditure.
The best dieting strategies I've seen track calories in and weight change. From their you derive calorie expenditure, and it really doesn't matter if you burned it or pooped it out, does it?
https://www.latimes.com/science/story/2020-02-04/calorie-cou...
Being wrong about the number of calories in almonds doesn’t count as evidence that skinny people are skinny because they poop out undigested calories.
Also, I’m not saying digestive malabsorption is impossible, just that you shouldn’t assume it unless you have strong evidence to the contrary that doesn’t have another simpler explanation.
1. Log everything you eat each day.
2. Weigh yourself first thing the next morning, before eating.
3. Track the trend (did you gain, lose, or maintain?)
Over time, clear patterns emerge. You start to see exactly how your intake maps to weight changes, and you can fine-tune accordingly. It’s not guesswork, it’s feedback.
What surprised me most was how little food I actually needed. Even with regular strength training, a modest surplus was enough to support muscle growth.
(Hell, CICO isn't even valid for something as "simple" as an electric vehicle. My EV's end-to-end efficiency is quite a bit different depending on whether I'm charging from 120V or 240V, the outside temperature at charging time, the outside temperature at driving time, and a handful other factors like state-of-charge. The human body is even more complicated.)
I wish I never read IIFYM when I was younger
Study after study has shown that people who claim to not be able to lose weight via diet simply do not have any idea how many calories they are actually eating.
What do you propose to do about that?
But the fact people over eat so readily is most likely down to the heavily refined food we eat that our hormones aren’t tuned to handle in my opinion.
I know I was miserable on CICO as Iw as constantly going through cycles of gaining then losing lbs. Whereas once I switched to a whole food diet I no longer even need to think about the calories I eat, I just eat when I’m hungry. And I don’t even crave the cookies and marshmallows at all
People overeat for a variety of extremely complex reasons. Mental health, stress, hormonal interactions. gut microbiome, dopamine deficiency, and on.
The assumption that forcing yourself to eat less is solving the root cause is not sound, in my opinion. If you look at GLP-1 inhibitors, those appear to be a much more root cause solution. Rather than solving over-consumption, they solve the propensity to over-consume, which then solves over-consumption.
What we really need to be looking at is why some people have a propensity to over-consume and why some don't. Why are some people destined to a life of constantly fighting food when others don't have to try at all and they stay thin?
Just intuitive, I know this is also the case for other substances like alcohol. I've never had to struggle with alcohol and I never will. I just drink whenever and never think about it. But for some people, it's a lifelong struggle. They have to constantly be thinking about alcohol, and every time it touches there lips it's a problem. Why? Is it genes? Our environment? Psychological support in childhood?
The mechanism from article really does suck, but what does that have to do with CICO? While white adipose cells are created, it's still excess calories that fills those cells.
No, CICO IS the practical diet. Satiety, microbiome, none of that shit matters. All excuses to not properly stick to the diet. You weigh your food, calculate the macros, and that's it. Zero thought required past that.
It is literally impossible to not lose weight even if you are eating nothing but 500 calories of pure corn syrup every day (Though you may feel pretty sick)
So, I maintain that, yes, CICO works and calories + macros is the most important. But unless you control intake 100%, then the types of food you consume affect how much you eat, energy levels and compliance. This is especially true long term (over 5 years).
I like to compare it to programming. If you tell a C++ developer that their software should have good uptime, your advice here is the equivalent of saying "don't have memory leaks, null pointer dereferces or use-after-free". Yes, all true, but everyone know that. What we need are behaviour patterns like RAII, an extensive test suite, running those tests in valgrind/ASAN, etc. that actually help in a forward looking perspective achieve this goal of not making those mistakes which lead to poor performance.
If they can't have the discipline for CICO, why would you give them benefit of the doubt they have the discipline to "follow" the other methods? It makes no sense.
Adherence is way more important than getting pedantic about thermodynamics.
People can do intermittent fasting all they want, but if they're eating a stick of butter during feeding times, its worthless. Eating to satiety is useless as a marker because satiety is subjective.
Measuring your food does not give you an excuse to cheat, except the person simply choosing not to do it properly. There are no weird ways of getting around the fact that you have a maximum calorie limit, and thats it.
Of course satiety and gut microbiome matters.
I'm thin. Do you know what I do to maintain that? Fuck all. I eat what I want, when I want. Do I exercise? No.
Why is it that I don't have to try at all, but you do? Shouldn't you be a little curious, a little jealous? How cool would it be if you could maintain what you have now, but without any of the effort?
There's a lot of stuff I don't care about. I don't care about alcohol consumption either. I drink what I want, when I want. And it works out great for me. For others, that plunges them into a life of alcoholism and they die young of cirrhosis. Why? Why does it work that way? Why is it that I can do whatever but other people can't?
These are the questions we should be asking. You're solving the symptom, not the cause here. Eating too much is a symptom. The root cause is the propensity to overeat. I don't have that propensity, so guess what - I never have to try. But why don't I have it? Will I one day get it?
Related discussion: https://news.ycombinator.com/item?id=42376760
I lost 150 pounds in 2 years and all I did was eat less, and I kept it off easily. I'm not curious because I saw pictures of myself before I lost weight and I saw the plates of food in front of me and it was absolutely disgusting amounts of food.
I feel sick when I eat large amounts of food and I like to keep it that way, and all it needed was getting used to eating less.
Some people…
I don't have to try at all, you had to try a little, and some people have to try a lot. And that's why we're seeing a variety of experiences with obesity.
The difference is, I recognize there must be something about my genetics, or my way of life, or my upbringing, or whatever, that gives me such privilege. You, however, have zero humility, and simply believe yourself superior. I doubt it works that way.
I mean, I have plenty of other problems. I have no discipline, no self control. And I'm thin. So... it's more complicated then you give it credit.
I personally don't think that anyone without enough will power and discomfort tolerance to feel hungry for long periods of time when surrounded by limitless food should be forced to live a shorter more painful life.
The key to getting people to quit smoking is for them to stop smoking. Very simple. Why on earth do we have nicotine gum and patches?
Not the GP, but based on their abstinence-only sex comment I imagine the point being raised is that it's something that is technically true but not a practical guideline.
CICO is a true statement. But you're not going to be able to accurately measure CI and especially not CO. So why bother using that as your guideline on how to proceed? Instead it is known and understood that there are mechanisms for things such as improving CO efficiency, and it's much more practical to focus on that.
It doesn't though, at the end of the day there's an objective amount of CI and an objective amount of CO. Further, CO isn't just "activities", for instance you burn calories merely by existing. Things you're describing will impact CI and CO, but at the end of the day if one had the ability to fully and 100% accurately measure CI & CO it'd be apparent that the math works.
But this is why "it's just CICO" is at best a tricky phrase. Because the hard part is in the nuance you describe.
Math truth is not always good policy guidance.
It is true that CI==CO. It must. It is not true that telling someone that CI==CO is a good way to get them to manage their weight, because (as mentioned) it's hard to measure and (as I added) even if you measure correctly, you _reduce likelihood of compliance_ by ignoring appetite effects when you call all calories equal.
I think we agree, just trying to find the right words anyway.
A 5K run for 30m burns ~300-600 calories. A single serving of a candy bar is ~250 calories. You NEED to restrict the CI portion since its the easiest part of the equation to control.
The typical person who is maligning CICO because it doesn't explain why they're still fat, that person would do much better by better focusing on CICO and performing the all time best exercise for weight loss - the "table push away"
Meanwhile the typical strict advocate of CICO as the end all be all also needs to understand that there's a lot of nuance in both the CI and CO variables.
People who staunchly support CICO as the end all be all talking point miss what you describe. At the same time people who decry CICO as being bogus are missing what I describe. Both are true and both are wrong. It's really just a semantic argument.
Of course, greatly over-simplified models are still useful. CICO as a useful first approximation of a diet still has its uses and its places where it is more useful than some alternative models.
I think food calories and the way we talk about them (like food "contains" them, always burning them) feel a lot to me like the last bastion of Phlogiston Theory in any of the sciences. Chemistry has moved away from the "Calorie" as an approved unit of measure for the more accurate/more reliable "Joule", but also to remove some ties to old Phlogiston baggage.
I think most people would laugh at this idea pushed to its current Physics extreme that food should be measured in Joules by Relativity's infamous E = mc^2 mass-to-energy conversion ratio and that we should assume that the human body is some efficiency percentage of an ideal spherical fusion reactor. Joules In/Joules Out, right?. Why does it sound more accurate to so many as a model when it is "heat particles"/Calories?
(Which again, isn't a call to entirely toss the model, it serves many as a first approximation well enough. But it seems past time to develop better, more targeted models.)
> As Clotaire Rapaille wrote in his terrific book, The Culture Code,
“Years ago, Tufts University invited me to lecture during a symposium on obesity.
Lecturer after lecturer offered solutions for America’s obesity problem, all of which revolved around education. Americans would be thinner if only they knew about good nutrition and the benefits of exercise, they told us. Slimming down the entire country was possible through an aggressive public awareness campaign.
When it was my turn to speak, I couldn’t help beginning with an observation.
“I think it is fascinating that the other speakers today have suggested that education is the answer to our country’s obesity problem,” I said. I slowly gestured around the room.
“If education is the answer, then why hasn’t it helped more of you?”
There were audible gasps in the auditorium when I said this, quite a few snickers, and five times as many sneers. Unsurprisingly, Tufts never invited me to lecture again.”
* Or its proponents say it says