[Frost1x]

>The question how do we explain why people without insulin are able to stay thin, while eating massive amounts of calories with the CICO model. Because that case is breaking the model.

To my knowledge this doesn't break the CICO model. The disease (e.g. type 1 diabetes) reduces or eliminates production of insulin which triggers metabolism of glucose. Since you're metabolizing less (or no) glucose, you're not gaining as much energy and passing most all that out through waste.

If you have a disease you need to consider that your energy expenditure isn't inherently going to be the same as studies estimating from healthy individuals. This doesn't break the model, it just means your intake and expenditure are different than most healthy individuals. People with hypothyroidism have similar issues. Is the CICO model great for these people? If you account for such factors the underlying principles should hold true.

[mister_mister]

I'm afraid that is incorrect, type 1 diabetes still have glucose metabolism, with diabetes type 2 glucose metabolism could be impaired but with type 1 that is not the case.

What has changed is that without insulin glucose will stay in their blood damaging organs and veins.

Insulin signals to cells take up glucose and other nutrients, first organs like the liver, then the muscles.

More information in the link from healthline. https://www.healthline.com/health/diabetes/insulin-effects-o...

[jonnycoder]

You just proved his point. If two people eat 10,000 calories and the one with type 1 diabetes is passing most of it as waste but the other person is storing that in the form of glucose and fat, then CICO is broken in that example. But like you say, account for such factors and the principles hold true; how do we know there aren't factors yet to be discovered?

[Frost1x]

How does this proove the point? In the example given, the diabetic is expending more calories (through waste) than the non-diabetic... the model still holds valid. The diabetic has less net calories absorbed by their body.

>how do we know there aren't factors yet to be discovered?

We don't and can't (by definition), that's part of the scientific process. Part of that process requires us to find evidence to the contrary or provide a viable testable competing argument. We don't just waive our hands in the air and claim magic gremlins are making people skinny or fat since there are likely limits to human understanding and knowledge, especially at any given specific point on time.

Most the evidence out there, that I'm aware of, vehemently supports the CICO model and it makes sense as a complex system resting up very well studied chemical and physical phenomena. The only thing broken seems to be a general understanding of the model being discussed.

[librish]

The point is that when people say calories IN they normally refer to what you put in your mouth, not how much your body absorbs.

[mister_mister]

That is problem with CICO proponents start with scientific terms. But it always ends up with magic what does or does not count based and whatever the argument they are in. CICO models doesn't state anything they claim, but it in the end it's argument into nothing. Because human cells does not use calories it uses ATP through the kerb cycle. That whole process so bizarre complex, and then also based on so many confounded factors, that CICO is just too simplistic and it's almost impossible to lose weight and keep it off according to the model. Link to study about how the biggest losers contestants are doing after the show. Hint not well...

https://www.health.harvard.edu/diet-and-weight-loss/lessons-...

[laserlight]

I find this interpretation of “calories in” very uncharitable. We certainly don't argue over whether eating coal makes one fat. Coal has lots of calories, but we're interested in metabolically available ones. If type 1 diabetes people cannot metabolize glucose, then it doesn't count as in.

[mister_mister]

They do have glucose metabolism[0], but that is the issue with CICO model already you have to start making extra rules about what is digestable and what is not. Calories doesn't state that all. Offcourse it wouldn't because the Calories concept was made for steam engines in 1800's.[1] Not that is matter from when it is. But maybe it's time for new ideas that do explain that conundrum of those type 1 diabetics. The Carbohydrate-Insulin Model of Obesity[2] does have a explanation.

[0]https://www.healthline.com/health/diabetes/insulin-effects-o...

[1]https://en.wikipedia.org/wiki/Calorie

[2]https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6082688/

[laserlight]

> extra rules about what is digestable and what is not. Calories doesn't state that all.

I wouldn't call those rules “extra”. After all, we're talking about human metabolism and what is digestible or not is central. The calories we're talking about under this topic has nothing to do with steam engines, except that both steam engines and humans take some input, called calories.

I don't see any conundrum with type 1 diabetes. They might have a different metabolism that counts differently which calories are in.

By the way, do you have a reference for this claim of yours [0]:

> people without insulin are able to stay thin, while eating massive amounts of calories

[0] https://news.ycombinator.com/item?id=34518288

[mister_mister]

So how do we calculate Calories In and Out according to you? Becausr it sounds like that we have to deal with real world that really complex digestion, hormones, gut biome. You just start adding and subtracting numbers.

At that moment CICO dies, because you won't be able to measure anything and just have black box which you give whatever number makes sense in the end.

Not that it matters because the cells in human body use ATP not calories. As such calories are at best a proxy for how much food.

But that is issue with CICO, it's like magic box and we only have to count IN, as much at what makes the calculation correct later on, also with OUT. That is not very scientific. Because we are unable to reproduce anything.

I have posted the article before, have you read it? https://www.everydayhealth.com/eating-disorders/diabulimia/

[laserlight]

A model being difficult or tedious to quantify doesn't make it false. And, all models are wrong, but some are useful.

> But that is issue with CICO, it's like magic box and we only have to count IN, as much at what makes the calculation correct later on, also with OUT. That is not very scientific.

The whole physics is a magic box. We find qualities of materials after we measure them, because that's how the model is constructed.

Let's say that I have a model called mass in volume out (MIVO). It states that mass of a liquid predicts its volume. We measure how much volume a certain amount of water takes, vary the amount, see if the model works, and it does. But a MIVO-denier is not happy, because our measurements with water doesn't reproduce with mercury. Well, duh, because they have different densities. MIVO-denier is still not satisfied, because now they have to go through the tedious task of finding the density of the material they have to work with before being able to apply the model. Furthermore, they have to keep the temperature constant, not mix liquids, etc. Yet, MIVO works regardless of how difficult it is to quantify, measure, or use.

PS: Thanks for the reference. I had missed it.

[sn9]

You have several misunderstandings of basic science.

"Calories" are simply a unit of energy. The energy released by the utilization of ATP can be measured in any unit of measure you like for energy. It won't change the fact that the unit can be calories.

This is like arguing about Celsius vs some other unit.

Likewise, the CICO model has been replicated over and over again in high quality studies that don't rely on self-reported intake. And this model and information are used by thousands of people every year to manipulate their bodyweight and composition at will in sports like bodybuilding or ones with weight classes.

Indeed, treating the body as a black box makes this even easier as tracking caloric intake and your bodyweight is sufficient to do this and apps like Macrofactor do all the math for you.