Quick hit: Not as easy as calories in =/= calories out

Next time someone says to you that maintaining weight loss is as simple as calories in = calories out, show them this.

So really, what is going to make me live longer – getting fit at the size I am at and allowing myself to enjoy food, or obsessing over every single calorie for the rest of my life?*

There is also a lot of unpacked privilege in the weight loss debate. As one of the people mentioned in the article says – her calorie counting is somewhat easier because her children are grown and she is retired and can take the time necessary to do the large amount of exercise and diet planning every day that is necessary for her to be able to maintain her current weight after her weightloss. It does not take into account finances, ableness, caring responsibilities or any other circumstances (apart from childcare and work) that may make it more difficult for someone to follow this regime. So is this what the 5% do to maintain long term weight loss? Is the ability to maintain weightloss also about invisible privilege?

SotBO: It’s all about me! This may not reflect your personal situation, nor is it intended to.

Categories: Culture, culture wars, health, Life, media, medicine, parenting, work and family

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11 replies

  1. Perhaps I’ve missed something in the article but I don’t think there’s anything there that contradicts a “calories in/out” theory. But it does explain that different people at the same weight will have a different amount of calorie requirements. I think its been fairly well accepted that different people have different idle calorie consumption rates. There’s an implication that there may be different calorie consumption rates for the same amount of exercise as well – though I don’t that is particularly new or controversial either. Obviously there has to a be a minimum amount of energy consumed for a given amount of exercise (the human body can’t be more than 100% efficient at converting energy), but there’s a lot of room for people to have quite different efficiency levels.
    What might be interesting, but the article doesn’t cover, is if there has been any research into whether people start out life with significantly different idle/active calorie consumption rates or if its something caused by cycles of gaining/losing weight.
    Totally agree that life circumstances are quite relevant. I’d be pretty confident for example that it would found that statistically speaking men also put on weight while their partners are pregnant and during the early years of their children because they simply have less time to do exercise like activities (and I think sleep deprivation has been linked to weight gain).

  2. Calories in/out is technically correct. It’s also not accurately measurable in any consistent way, nor is it a helpful guide to what to do.

  3. I think what the article is trying to say is that calories out = something quite different for people who were previously heavier and who have lost weight because they must go into battle with their body which wants to retain the weight. Therefore the simplistic calories in = calories out is not as easy for them as their calorific expenditure is much lower than that of a person who has not tried to lose weight and whose body is not battling to maintain their previous weight.

    So shorter me: telling someone to eat less and exercise more is not going to work for long term weight loss.

  4. I have to admit, I love the way they document the study. It’s like hey, hundreds of thousands of (mostly female) former dieters can’t possibly have been either correct or truthful when they said they either stopped losing weight, or worse still, gained weight back despite sticking to diets. $DEITY No! They have to be lying to themselves and everyone else. Or just wrong in general because they’re female. Or fat. Or both.
    I’m glad this (male, university professional) doctor in Melbourne was willing to actually perform a study on this matter, if only because now there is possibly, possibly some verifiable evidence pointing to one of the happy truths that the size-acceptance movement and the HAES movement have been jumping up and down and yelling about for the past fifty years or so: weight-loss dieting does not work for the majority of human beings, for the majority of the time. It produces a short-term weight loss, but then it also produces long-term metabolic changes which result in the weight being gained back, and in the body physically and physiologically slowing down to cope with the reduced dietary intake.
    To be honest, that entire article really needs someone to go over it and unpack it, from go to whoa – unpacking for privilege, for bias, and for blithely swallowed assumptions (nobody has ever said that there is nobody at all for whom weight loss dieting works – what’s been pointed out instead is that there’s a far greater prevalence of people for whom it does not work; the 10,000 people being tracked by the [US] National Weight Control Registry are a statistical drop in the ocean – in order to actually track their statistical significance, one would have to compare their numbers against the number of new dieters who are enrolled on weight loss diets each year in the US alone – I’m willing to bet it’s a number greater than 200,000). The sad truth is that there’s a number of multi-billion dollar industries which are making a lot of money out of selling weight-loss dieting as a viable product – despite it’s known 95% failure rate and they aren’t going to take any amount of counter-evidence as a reason to stop selling it to us.
    The weight-loss, bariatrics, obesity, cosmetic surgery, fashion and marketing industries are as attached to their product and profits as the tobacco and alcohol industries are to theirs. There is money to be made from making people miserable, making people unhealthy, and making people dead – and that is all that matters.

  5. Ah megpie, I think I love you!
    I was threatened with psychiatric commitment as a teen, and in my twenties, for “persistently lying” to doctors about my food intake. Hospitalisation, I was told, would allow them to “prove” I was lying.
    A near-death incident (from the real, undiagnosed cause) and a new medication later, and I was 7 stone lighter. Were they pleased? Nope. One doc said that amount of weightloss in 4 months wasn’t enough, the other said it was too much, I was anorexic, and needed a stay on a psych ward!
    Just. Can’t. Win.
    Now, as a chair-using, largely immobile cripple (due to yet another potentially fatal condition being written off as laziness, greed and hysteria) I’m being told that my obesity is hindering my progress. And that I could benefit from eating less and exercising more.
    Hmm. Thanks able bodied, skinny doctors, but no thanks. If going for an unscheduled piss requires oramorph and a nap, and two consecutive days of having at least one meal is a “high intake” period, then I won’t be hitting the gym or eating even less any time soon, cos as limited as my life is, I don’t wish to end it.
    Privilege keeps people from seeing that it isn’t always as simple as “stay under 1500cal and jog around the block every day”.

  6. I’m curious as to why people keep on doing experiments with low-calorie liquid diets, when we’ve known since Stunkard and McClaren-Hume’s study in 1959 that this puts people into starvation-mode — ie, it makes one’s metabolism super-efficient, so that it draws out and stores as much energy as possible from all food. (Not to mention some rather horrible psychological side-effects.)

  7. Beppie: Not to mention the bizarre lack of scientific connecting-the-dots on nutrition and micronutrients. Over and over again we find that epidemiologically, the people who live longest are the people who have a joyful food culture including a variety of fresh and fermented foods. Over and over again we find that fresh foods contain a whole lot of micronutrients that we haven’t put into pills yet – and that replacing the ones we have put into pills with their pill form instead of the fresh form can have the opposite effect of that intended (and can, in some cases, cause cancer).
    I’m yet to see a study where people who subsist on formulated factory dairy diets do better that people enjoying fresh foods, and I’m not holding my breath.

  8. Actually, there is a fairly simple, verifiable, no-nonsense way of measuring calories-out. That still leaves the tricky calories-in part, but atleast it’d be helpful in showing to which degree diets tend to reduce the burn-rate.
    The method is doubly-labeled-water. Wikipedia has a detailed explanation, but the gist of it is, you give people a glass of water to drink where part of the Hydrogen is deutrium, and part of the oxygen is 18-O. Hydrogen only leaves the body as water, while Oxygen leaves as water or as CO2. CO2-production is directly linked to calories-burnt. A urine-sample and a mass-spectrometer a week or two later will thus give a pretty accurate (+- 5% or so) measurement of the calories burnt over the intervening time-period.
    I wish there was a similarily simple way of measuring food-intake.

  9. I am interested in the findings of the article. I wish the article itself wasn’t so blatantly fatphobic. “No one wants to be fat”? Fuck you!

  10. Um, you know why their bodies thought they were starving? BECAUSE YOU GAVE THEM 550 CALORIES A DAY.

  11. We do have an obsession with body image these days. My SIL had cancer and lost a lot of weight. She lost count of the compliments she received, “you look great, you’ve lost so much weight”….she had reached the place where your head looks too big for your body – very underweight. Fortunately, she recovered and returned to her normal weight.
    Amazing that the compliments about her weight were at a time when she was ill and unhappy, but now she’s normal weight, or a bit overweight, healthy and happy, the compliments have stopped.
    I’m a bit overweight, but refuse to allow that to dominate my life. I do what I can, try to eat sensibly and walk every day – and enjoy life. No point beating yourself up about it…low self-esteem doesn’t help. I think it’s more than calories in – calories out – we all know active people who gain weight easily and struggle to lose it and people like my friend, always tall and thin and at 45 can still eat everything in sight without gaining weight.

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