Comment by dahart
3 years ago
Except we have literal truckloads of data on calories and metabolism. Like a lot of human physiology, these things come with Normal (Gaussian) distributions in the human population. There are averages and deviations we can talk about, without having to understanding anything about the inner workings of the human body, right?
I couldn’t agree more that CICO is a super blunt instrument, but it actually does work, because the alternative we’re comparing to is not tracking input & output at all. You can be a lot wrong, and it’s still better than completely wrong, right? :P Like the amount of noise in my calories estimates is probably at a minimum 10%-15% wrong at all times, same goes for expenditure (maybe even worse) but it seems like the important part isn’t actually the number, it’s the act of establishing and sticking to a budget. For me, mentally, it was the realization that my feelings on hunger and satiety were actually mis-calibrated. This helped me get over the idea of being hungry, and helped me realize the goal wasn’t to overcome hunger, it was to get used to something closer to the correct amount of food.
> 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.
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?
> 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.
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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?
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