[makeitdouble]

> truckloads of data on calories and metabolism

We have, but most of it seriously flawed because of many issues.

For instance this pretty serious study on diets (http://www.dishlab.org/pubs/MannTomiyamaAmPsy2007.pdf) had to rely on BMI for segmenting the subjects because the whole field had standardized on BMI. Yet we know for decades that BMI based segmentation is meaningless, BMI itself being a clunky relic of the past. Then you can come down on the subject of the studies, repeatability, no possible control group most of the time etc.

We can say that's the best we can do, but we should also accept it's far from being reliable info most of the time.

> it actually does work

well, it doesn't work or not, it's just a concept, an observation like a law of physics. It's like saying gravity works, that's not the info you'd give people having difficulties to build a self balancing robot.

[dahart]

Those statements are technically true, but I’m not exactly sure what you’re trying to say. There’s nothing flawed about observational data that ignores the inner workings of the system, that’s how all of science works. Like you say, it’s physical observations. There’s nothing flawed about measuring wattage output of exercise while keeping food intake constant and noting that most humans lose weight under such conditions, or of keeping caloric output constant and increasing caloric input and noting that most humans gain weight.

> it doesn’t work or not, it’s just a concept, an observation like a law of physics.

It works as a tool for weight loss. It works for exactly the reason you state, because it’s primarily an observation of physics. The only way I gain mass is via my mouth, and the only way I lose mass is via energy expenditure. If I want to control mass, therefore, tracking and controlling my input and output is more or less guaranteed to work. For sure the input output responses might not be perfectly linear, but that’s expected and not a ‘flaw’. The weight response to calories also can’t be reversed or flat, due to physics, it must be highly correlated, right?

[zargon]

> If I want to control mass, therefore, tracking and controlling my input and output is more or less guaranteed to work.

It's wonderful that your physiology is aligned with your goal of doing this. But in this control pathway there are billions of neurons, trillions of bacteria, I don't know how many biochemical signals, all feeding back into each other. Reducing all of this to "controlling input" is one of the most harmful ideas in public health. For people who struggle with weight it is just setting them up to fail and blame themselves for it. Repeated over, and over, and over.

[dahart]

I’m sorry. I truly empathize. I can only apologize for what it sounds like. I do understand what it feels like to hear this stuff. I felt the same too, for a long, long time. I don’t actually know how to speak about what I think I’ve learned in a way that doesn’t come off as demeaning to some people.

FWIW, my personal philosophy on tracking and controlling my inputs is almost completely focused on figuring out how to turn this away from a “self-control” or willpower problem into a better understanding of what I want. Personally, I think trying to willpower control over eating is absolutely doomed to fail. It’s nearly impossible to meet a budget when you’re expectation is based on being strong enough to overcome hunger. For me, solving this was a mental problem of convincing myself it’s not about willpower at all. I say that like I solved something, but in reality it’s still hard.

I was only referring to the accepted fundamental truths about all human physiology, for instance that food is necessary to live, and that exercising uses some of the food. Even for outliers who’s bodies put on pounds when they merely smell food, measuring calories in and out still works reliably. The number of calories might be abnormal for some people, but they can still reliably calibrate their maintenance input and see effects when increasing or reducing it. I don’t mean for it to sound easy to do, because it’s not easy, I only mean to clarify the goals. The high number of neurons and bacteria and signals actually make this a more stable and predictable system, generally speaking.

[zargon]

> I was only referring to the accepted fundamental truths about all human physiology

CICO is fundamental to human physiology in the same way that "people become indebted because they spend more money than they earn" is fundamental to economics: true, but utterly useless for actually addressing poverty or obesity. An attractive red herring and a dangerous one.

(It's even worse than that: at least we can measure income and expenses. Yet we can't measure caloric intake / expenditure properly.)

[dahart]

I completely agree with you about poverty and obesity. Those are systemic problems and are going to take something else to escape. Choices are removed for people who get stuck in those black holes, and its true that saying “use a budget” isn’t helpful after those happen. It might be helpful long before, but the forces are too strong for people who are spiraling down or stuck there. So, I hear you and I think you’re right about that. I’m not suggesting CICO is a tool to fix obesity.

Moreover, poverty and obesity are related. Poverty is affecting people’s food choices, and the cheap food and fast food we have is a lot of high fat, high sugar, high calorie, and huge portions.

CICO is more useful for people who are stable and fine, not under the poverty line and not obese, but just a little unhappy with their weight. CICO is what bodybuilders and athletes and models use, among many others, people mostly fine-tuning. (Just like how financial budgets are mostly helpful for rich people, and people optimizing their savings, but not particularly helpful for a single parent on minimum wage who’s unable to meet basic necessities.)

For someone who’s not suffering from either poverty or obesity, the difference between money/debt and calories/weight is you can only get money from other people, where you only get calories from yourself.

It doesn’t actually matter that calorie metrics are approximate and not perfect. The reason is because CICO enables a personal science experiment, and a process that can adjust and adapt to imperfect information. What it enables you to do is to calibrate your measurement first. Then, second, either reduce caloric inputs or increase caloric outputs to lose weight while making sure the other one doesn’t change, or do both. For average non-poor and non-obese people, CICO isn’t a prescription, nor is it a dangerous red herring, it’s basic consumer information that is, some say, dangerous to not know, which is why part of the important response to the obesity crisis is to demand accurate caloric labeling on food, to enable consumers to make healthier choices long before obesity. This is only the tip of the iceberg, we need better sugar and portion control and all kinds of things, but it’s a start.

CICO is like a PID controller but even simpler than that, it’s only the wires of a P controller where you are the controller. The only thing CICO says is which input to connect to, and that’s all. A PID controller doesn’t know a thing about the system it controls, it doesn’t have to. All that matters is that the inputs affect the outputs and the outputs can be measured. As long as the system output changes over time with it’s inputs, this P controller setup works. It still works when the underlying system has defects and bugs or differences in manufacturing from other systems, as long as the underlying system is responding to changes in input.

[makeitdouble]

> CICO is what bodybuilders and athletes and models use, among many others, people mostly fine-tuning.

To nitpick, bodybuilders and athletes usually control their diet at a level where calorie counting is not relevant.

An example of that: https://youtu.be/PBfDWstg3Hc It’s interesting that the overlays always show calorie intake, but you hear the guy and at no point he mentions calories, ever.

He specifically mentions fat, proteins, vitamins, minerals, nutrients and overall quantity. He weights his food at each meal and he probably adjust all of these try and error style, looking at the results. I think calorie estimates are probably meaningless at this point.

[zargon]

> CICO is more useful for people who are stable and fine, not under the poverty line and not obese, but just a little unhappy with their weight.

Yeah. Calorie counting can be useful for normal weight people, like budgeting can be for financially secure people.

Looks like we are in violent agreement. :)

[makeitdouble]

Science work by repeating experiments: I give you a protocol, you repeat it controlling for the same conditions, and validate my results.

As you say ignoring the inner workings would be fine if we had consistent, culture independent widely reproduced results. Thing is, we don’t.

For anything beyond a clinical trials on specific subjects that stay there for days/weeks to be fully studied, we might not even have valid control groups.

This is why I see comments on us having a vast body of studies to look to be more or less a “look a my library, there’s a lot of books” kind of statement that doesn’t really point at us having actual vast knowledge about the subject.

> It works as a tool for weight loss.

Does it ? to get back to the above point, do you see any consistently reproduced studies on large cohorts of people pointing at it working in the long term?

[dahart]

Still not sure what you’re trying to say. Are you skeptical that reducing caloric intake works? Or skeptical that counting calories helps to reduce caloric intake? Are you skeptical about whether calories are a metric? What exactly do you think doesn’t work, and why? Why are you claiming that we don’t have culturally independent results? I don’t believe that’s true.

If you’re asking whether calorie counting has been studied and controlled enough to know if it works as a weight loss tool in practice, the answer is yes. You don’t need a study for this part; it’s physics. If you are maintaining weight and then stop eating you will die. If you are maintaining weight and then cut your diet in half you will lose weight. I posted a link to one survey on this somewhere in this thread that should be easy to find that demonstrates the rate of metabolic adaptation to caloric restriction (it’s about 15%). But you can Google this and find out for yourself, there are many many papers in many many languages, and you looking for your own sources will be better than being skeptical of anything I suggest. The health agencies of every developed country in the world publish caloric recommendations and have resources and research information available.

Literally millions and millions of people globally have successfully used CICO to manage weight, and the primary complaint is not that it doesn’t work, the primary complaint is that it’s difficult to implement and make habitual, it requires too much work and/or control. When most people say “it doesn’t work”, what they mean is “it doesn’t work for me because I couldn’t establish a working routine, the habit doesn’t stick easily.” There are no studies showing normal people reducing their caloric intake significantly and failing to lose weight.

[makeitdouble]

> If you’re asking whether calorie counting has been studied and controlled enough to know if it works as a weight loss tool in practice, the answer is yes. You don’t need a study for this part

This is the shortcut I am pointing at.

You're bringing in a pure assumption. I need an actual, well designed study that shows that your inntuition is in fact correct (to reiterate we're talking weight loss, and in particular stable loss, not some blimp in a three weeks trial)

Can you point to a rock solid study on it? There are countless studies on the most obvious things. Take any of what you call "physics" and you'll have large studies from reputable research labs analysing the long term impact on stricly controlled groups. CICO is not some hippy unknown strategy, the press turns around "obesity crisis" headlines year long, there is no shortage of funding for research."It's obvious so nobody tested it" isn't a valid argument.

[dahart]

Hey listen FWIW, I’ve been overweight (and am now TBH, gained quite a few pounds over the pandemic). I don’t think the obesity crisis is a failure of CICO, I think it’s a failure of big business interests and social engineering and advertising and economics. I don’t think using CICO is easy, I know for a fact, first hand that it’s hard. I don’t think overweight people lack self control, I think that humans evolved to be afraid of hunger for a good reason and that our standards for beauty are completely distorted by mass media.

I’m trying to understand, but I don’t yet understand your objection to the physics. Do you disagree that failing to eat enough will cause death? That’s not an assumption, right?

Here’s the study I mentioned elsewhere in the thread. I have no idea if this meets your bar for size or quality. It feels like you’re trying to set the burden of proof as to be so high that you are ensuring it can’t be met.

https://academic.oup.com/fampra/article/16/2/196/480196?logi...

This argument feels to me like demanding rock solid study of a large cohort of multicultural evidence for gravity. Are there countless valid long terms studies demonstrating the existence of gravity? No, not really, because nobody anywhere denies that gravity exists.

CICO isn’t a specific methodology, nor is it a belief or a surprising theory. Calories-in, calories-out is a completely generic statement about the causes of mass gain and mass loss in the human body. It doesn’t make any claims about the amount of gain or loss. It doesn’t claim that eating a pound makes you gain a pound, it’s simply an observation that eating is the sole mass input of the human body, and energy expenditure is the only controllable output, the only way mass is lost. There are no other alternatives, right? Calories are an approximate measure of what you eat & burn. This is tautological, there is practically nothing to argue there, and there is nothing to debate. A study isn’t necessary because this is an already proven fundamental truth about the human body (and incidentally all life): there are no other sources of weight gain or loss. CICO doesn’t prescribe specific actions either. The way you use this information is up to you. The scientific among us might reasonably start measuring calories first to calibrate their steady state, and then slowly make changes to their inputs and outputs to see what happens.

Anyway, I also don’t need a study personally because it worked for me and it suddenly became clear what everyone who knows this was talking about. I had resisted trying it for a looong time, perhaps on the same grounds you’re resisting the idea. Better than papers might be to experiment on yourself, if you really want to know. First hand knowledge will certainly be more valuable to you than assurances from academics.

[makeitdouble]

> Are there countless valid long terms studies demonstrating the existence of gravity? No, not really

Yes, there are. There’s actually periodic assesments of gravity at most places to get an idea of the trends and detect underground movements. An exemple of this: https://earth-planets-space.springeropen.com/articles/10.118...

Surveying gravity is one of the many measures that are done pretty frequently and very seriously around the globe.

On CICO, the issue is it’s a model that is true at a very low level view of the body mechanism. You are right that it’s very generic, and in theory it makes sense. The disconnect is between that extremely low level view, and what you do with it in practice.

There was this excelent discussion on type 1 disabetes (https://maori.geek.nz/the-unreasonable-math-of-type-1-diabet...). These people have their life on the line and actually monitor their blood levels, and it’s still tough to manage a good guess of the inputs and when/how much sugar will get in the blood. Reading the labels doesn’t give enough info on what will be actually processed, and the real solution becomes real time constant monitoring of the actual blood levels, without relying on a model of how it’s supposed to work.

When you advocate counting calories for a random person on the street, they won’t monitor their blood, they actually are in a worse position as what they care about is not sugar levels but their whole body intake, which there is no way to monitor. And you also won’t be hooking CO2 masks on them everyday to monitor their out, so it’s also a random guess. At this point CI has crazy large variations, and CO is basically unknown, especially as it will change as they change their CI. This is why applying a CICO thinking for someone who’ll change their diet for the rest of their life makes no sense.

An argument I’ve often seen is to just lower CI to the ground until seeing effects. Which basically means obliterating the subjects social and professional life and ask them to keep it that way or it will be their fault if they rebound. That’s not what I call a weight loss strategy.

On the linked study:

It’s a meta study based on three prior papers, one of them is “ Decrease in fat oxidation following a meal in weight-reduced individuals: a possible mechanism for weight recidivism. ” https://europepmc.org/article/MED/8596485

From the abstract: > Twenty older (age:mean +/- SE, 61 +/- 1 years; range, 56 to 70 y) obese (body mass index > 32 kg/m2) subjects (12 women, eight men) completed an 11-week dietary restriction program in which they lost 9 +/- l kg.

So the research is on 20 “obese” people. Aside from the low number of participants, there’s not even a “healthy” control group here. They’re “obese” by their BMI but they might as well be gym trainees, who knows ? It only lasted 11-weeks, there is no mention of the social conditions of the study ([EDIT: I didn’t realize at first look that all participants where elderly. Which brings in more questions IMO, but I don’t know where to stand on that). So this study is aimed at bringing a single piece of information, but we don’t have enough context to extrapolate that info’s validity in any other context it does it apply to any population at large? are the effects permanent ? do we even get the same effect after 1 month ? was it random fluke from the limited test subjects ? who knows). The title is about weight recidivism but there is 0 follow up on the subjects outside of that 5 hour post meal check.

And that’s just the first study. We could go on and on, my point is we don’t have the “science” on the subject, just a ton of questionnable data points and random intuitive theories, everyone with their beliefs and prejudices.

Athletes have the means to control a lot better what they do, including adjusting everything to their actual body without having to care for grand theories. And many people succeed in getting healthier in many different ways, including by going to different diets that actually increase calories as counted and little change in their daily life.

That’s why I feel it’s a disservice to preach a “one true theory” when it doesn’t help much really.