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Comment by makeitdouble

3 years ago

> 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.

    • 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.

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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?

    • 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.

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