I think a third major thing is that people often have very skewed ideas of how many calories things have, like you decide to have a salad instead of a burger at a restaurant because it's the "healthy" choice, but often, because of the dressing, the salad will have as many calories as the burger, and then you feel like you were "good" so you have dessert!

Or people will try to do something like cutting the 30 calories of cream from their coffee, while leaving their 1,400 calorie lunch untouched, trading big expenditures in effort and habit changing for tiny calorie improvements.

Related: a common mistake is treating foods as binary “healthy” or not. Nuts, for example, can be “healthy” but ten handfuls is probably excessive.

Everyone knows the principle of calories in calories out. That’s not the issue. The issue is the huge array of factors - including economic, social, physiological (particularly hormonal) and emotional (particularly subconscious emotional) that influence the volume of calories in and out. If it was just a case of making conscious choices to consume fewer calories and expend more, there would not be the widespread problem there is. Clearly there is more to it, which is why people are downvoting you. You’re not making a point that everyone hasn’t heard before a thousand times.

People like to say that it's something else, in my experience, because they do, in fact, know what CICO is, and have tried it, and have failed when they tried it.

With broad strokes, those failures can be lumped into 2 categories: 1) lack of willpower (pretty self-explanatory) and 2) hoodwinked, bamboozled, and otherwise tricked by food package nutrition labels.

It is genuinely hard to discern real calories consumed using just food labels, and not 3rd party sources and at-home food scales.

That's the part that people don't understand, I think.

Source: I was fat, now I'm a little less fat because of CICO. Still kinda fat, but getting less fat slowly. I learned early that nutrition labels are your enemy and are just another marketing tool used by savvy companies.

I had lost weight without counting calories. CICO works, but it didn't work in the long term for me.

My method of losing weight and eventual weight maintenance, is intermittent fasting.

It just means that I don't eat for long periods of time. Every week, I undergo a 48 hours fast and for the rest of time, I effectively only eat one meal a day.

IF is CICO.

CICO does not mean counting calories. Counting calories is just the most direct diet. IF and Keto end up doing the same thing, just differently (and it's potentially easier for some).

What do you mean by your distain for food package nutrition labels?

In the US it's tightly controlled. The only thing I can think of (calories wise) is that people only look at the per-serving calories and not the per-package calories. This has gotten better over the past 5-10 years but still requires people to actually read it.

I think the major problem with CICO is that advocates for it present it as if it is a diet when it's actually just an explanation for why diets work (or fail).

I've seen a lot of threads with people asking for advice on losing weight and inevitably someone chimes in with "Calories in, calories out." Great, but that doesn't provide any strategy or guidelines for actually losing weight. Calorie counting and tracking is a strategy (and so are many other things, like intermittent fasting, the potato diet, etc. As long as at the end of the day you are at a calorie deficit).

Additionally CICO ignores the reasons why people overeat in the first place. There are a lot of physiological and psychological reasons for that. Maybe someone is overweight because they eat to cope with trauma. Maybe they have a hormonal imbalance that doesn't properly regulate how full they feel. Dealing with those underlying issues is often more beneficial in the long run.

This is why I want it to be taught in schools. It's not a topic that can be fully covered in a 100 word post. People get mad at me for bringing it up and not covering everything.

Like duh, if you eat burgers and fries you're going to be hungry when you hit your calorie limit, and then cheat on the diet. Then it won't work. That must mean CICO is useless! Why bother teaching it!

I used to believe in that, and I felt my problem was I was eating too much and not moving around enough, however, I recently started a "lazy keto" diet and am currently down 30 pounds (back to a normal BMI - and I didn't even change how much I exercise). I don't watch my calories at all, nor do I starve myself. I just watch my carbs. It's been really eye opening.

There's a lot of talk online about how processed foods are making us fat and I think there's something to that. The CICO model doesn't factor in how our body processes macronutrients. We didn't evolve to eat the diet we're currently eating (ex: sugary drinks). I think there's something to eating a diet that's more in-tune with how the body works.

CICO doesn't mean that every diet that works counts calories. It means that all diets require the calories you consume to be lower than the calories you burn. Including keto.

Can some diets impact how many calories you burn? Sure. Not really to the extent that you need to worry about it, though.

Can some diets be effective but unhealthy? Of course. You can follow CICO and lose weight by eating nothing but twinkies[1]. That doesn't mean it's healthy.

At the end of the day, your lazy keto diet allowed you to consume fewer calories than you burned. You just didn't have to keep track.

[1] http://www.cnn.com/2010/HEALTH/11/08/twinkie.diet.professor/...

Great job on losing 30 pounds!

CICO still applies to Keto, the macronutrient breakdown is just more satiating for many people. It's important for people doing keto to understand this as

1) Keto has a dramatic water weight effect, so people can overindex on their early results "I lost 10 pounds in 5 days!"

2) If you go off track with carbs it becomes a terrible diet, you fall out of ketosis for multiple days and need equivalent carbs to feel ok, boosting your total calories very high.

> I don't watch my calories at all, nor do I starve myself.

The key question though is not whether you are paying attention, but whether they are down or not. It is possible that you are getting full on fewer calories.

It's possible, but if I am, it means protein and fat are better at keeping me satiated. The standard American diet is high in carbs, and it could be that processed carbs aren't very good at keeping someone full.

> it means protein and fat are better at keeping me satiated.

That's the whole point, and a key component of any CICO diet: finding foods that make you feel full with fewer calories.

We should be teaching CICO and that being fat is not healthy and not ok! This body positivity movement is BS and harmful. More personal responsibility and less excuses.

Knowing calories matter doesn't solve a thing. You pointing it out like it's a revelation indicates you don't understand the difficulty of what you expect.

Let's say you are now 120 lbs over weight. You know CICO. How long will it take you to get skinny, assuming you ate nothing at all until you hit your goal weight? A pound of fat is 454g. A gram of fat contains 9 kcal. Being 120 lbs over weight means you have to burn 9x454x120. Let's say your basal metabolic rate is 2000 kcal/day 9x454x120/2000 => 245 days of not eating a single thing. Is this a reasonable thing to expect society to adopt en masse? Do you think you could starve for that long? Could you instead only eat 700 calories a day for 3-4 years?

It's a privilege of both time and wealth in the US to be able to tightly control your diet and eat healthy, most American's can't afford the luxury. A more reasonable position is to just accept that some people are going to remain fat and focus on positive health outcomes for those people. 'Educating' them about simple arithmetic that doesn't change the fact that losing 100+lbs of weight is a multi-year commitment you cannot break if you wish a modicum of success.

I say this as a person who did lose 80lbs when I reached adulthood and successfully kept it off.

Edit re your edit: "Downvotes mean I'm onto something" is not a wise stance to take almost ever. I didn't downvote. but I'd wager the reason folks are downvoting you isn't because they hate trivially obvious facts, it's more to do with your analysis being shallow compared to the scale and complexity of the actual problem.

Not only is this post wildly incorrect, you also seem to have just given up with the populous?

I lose around 2 lbs per week at 1500 calories/day. This is pretty normal. 120lbs would be 60 weeks of that. Little over a year. You are completely off with 700 calories for 3-4 years. It's irresponsible to spout that nonsense.

> A more reasonable position is to just accept that some people are going to remain fat and focus on positive health outcomes for those people.

Unbelievable. You've given up.

Edit:

> but I'd wager the reason folks are downvoting you isn't because they hate trivially obvious facts, it's more to do with your analysis being shallow compared to the scale and complexity of the actual problem.

I'd believe you if a ton of responses weren't people claiming that insulin levels or how fat is stored is actually what matters.

"Given up" is an interesting way of putting it. Given up on what or whom? Do fat people want me to save and educate them? You're acting like I should be doing something personally about other people being fat.

I think it should be treated just like any other chronic condition, you try to be as healthy as possible within the paradigm. If you want to lose weight, great, but people starting to lose weight need to understand that the habits they are using will likely have to be permanent fixtures for the rest of their life. Returning to a "normal" lifestyle is how the weight was gained in the first place after all.

Irresponsible to whom? You are the one advocating for this exact kind of analysis, not me, I merely obliged you.

Your stated solutions below are 'ban food' and 'education'.

If you know anything about how fat people are treated at doctor's offices, 'stop being fat, eat less' is probably the first and last thing they hear at any checkup.

It's not working. ' Ban food' is intriguing, but I don't believe it's practical for, I hope, obvious reasons.

- I lose around 2 lbs per week at 1500 calories/day. I don't care about your anecdotal data. Show me your CICO analysis.

Do you control for water and glycogen loss?

What about exercise, what's your basal metabolic rate? etc...

> Irresponsible to whom? You are the one advocating for this exact kind of analysis, not me, I merely obliged you.

It's irresponsible to say that you need to be on a 700 calorie diet for 3-4 years to lose 120 pounds. That's so far from reality that it's irresponsible.

> Do you control for water and glycogen loss?

I lose more in the first week or so to what I assume is water retention. After that it settles into 2lbs/week.

> What about exercise, what's your basal metabolic rate? etc...

I wear a fitbit and allow myself more calories if I run (based on what it tells me). None of this needs to be perfect. If you're off by 100-200 calories a day, you'll still lose weight.

None of that matters, though. I have my number: 1500 calories. If I'm not losing enough, I'll lower it 100 at a time. Or if I'm losing too much, I'll raise it 100 at a time. That adjusts for BMR and mistakes in my calorie counting. Finding my exact BMR is wasted effort.

Edit: "If you're calling 1500 a day a crash diet, making up numbers, and think education is a pointless endeavor, then I can't continue this conversation."

I said previously, I don't care about your personal diet, as it has little to do with how the CDC should dictate policy. The diet I described was a crash diet.

'education is a pointless endeavor'. You are putting words in my mouth, my point, of course, was that knowing about CICO doesn't change the fact that weight loss takes a long time, is hard, and requires resources that many don't have access to. A word of warning, keeping it off is also hard when you've been fat, so prepare for that.

Since we won't speak again, I want you to interrogate why you are emotionally engaged with this topic. I had similar thoughts about how other people should behave when I discovered how to lose the weight, but realized only later that those thoughts made me view all fat people in a dim light, that it was ok to assume bad things about them, to view them as in need of 'education' like you advocate for.

If you ignore everything else I've said, please think about the perspective of a person who has lost 120 lbs, but is still 280lbs, and are receiving their 100th unsolicited lecture about CICO from someone like you. Most fat people go through that, from elementary school to adulthood in the US. It's pointless, they definitely don't want to hear about that from a stranger.

If you're calling 1500 a day a crash diet, making up numbers, and think education is a pointless endeavor, then I can't continue this conversation.

Your basal metabolism can flucutate based on physical activity, and probably nutrition too.

Also, fasting had shown to me that we can have an empty stomach and yet not be hungry. Yet, the state of not being feed seems to be a foreign idea to most people.

I lost weight by mostly intermittent fasting, without needing to count calories. Sometime, I even eat way too much food in one sitting. Over the long term, I did lose weight.

People who are 120 pounds overweight didn't gain it all overnight. It's completely unreasonable to expect to lose it all overnight either, and that fact has nothing to do with CICO.

The food-pyramid is honestly creepy. First, the order of foods is determined by invested corporations. Second, it’s arranged in a convenient shape (triangle) like some poser illuminati cult. Third, it’s taught to kids when they don’t know any better. Also, it’s even less readable than a pie-chart (angles are now replaced with surface area calculations), further giving it more mystical properties than quantitative guidance. It’s an appeal to psuedo-science.

I agree we should be teaching food fundamentals in schools, but it’s pretty hard when cereal and soda are so normalized. Normal food just tastes worse in comparison (I’ve lost count of the number of people who limit their food to chicken tenders). If you have parents who don’t cook, it’s pretty hard to break the cycle and your food preferences will likely shift to what’s readily available.

I think it’d at least be enlightening to show people how the food is made, so they could see for themselves. Perhaps they could have a lab where you make soda out of cups of sugar (or fry food)?

The nice thing about calories in minus calories out is, IF you maintain a calorie deficit, the laws of physics of the universe guarantee you must lose weight. The laws of physics are a pretty powerful thing to have on your side.

But that doesn't make it necessarily the most useful model for a complex animal to modify its own behaviour. We are dynamic systems that can voluntarily and involuntarily vary the amount of energy we expend. Our bodies send appetite signals to our consciousness, which can be pretty hard to ignore.

The only times I've consistently lost weight has been via a calorie deficit. But it's totally understandable that people want another model, either something like keto which purportedly produces weight loss without a calorie deficit by messing with the body's fat-storage mechanics in some way, or some behaviour+diet which produces a calorie deficit but with minimum lethargy and hunger. There's a lot of nonsense around dieting but the basic desire is understandable.

Your body can adjust basal metabolism to be lower or higher, based on physical activity level. IIRC, it can also adjust based on how much you're eating.

> I think so much has to do with these two points:

I think it entirely has to do with impatience and desire for a "tip" or "shortcut" to get where they want to go. Why diet (aka suffer) for 2 years to lose 100 lbs, when someone else is promising you can lose 10lbs a week for 10 weeks?

We want to believe there is a cheap, easy, fast, solution to all our problems.

Exactly. If you operate at caloric deficit (which can be achieved via caloric subsidies such as diet or exercise) you will lose weight. Even if your caloric deficit is achieved through processed junk, you'll still lose weight. Not a recommendation to do that, but, if you're simply optimizing for losing weight, it would technically work.

And also if you're gonna be tracking your calories, be liberal with the caloric value of what you're eating. There's some really messed up entries for caloric value of things in MyFitnessPal that extremely underestimate how many calories are in certain foods. Like an entry for a full-sized cinnamon bun that says it's 150 calories (just making up an example, but I've seen things that absurd)

Too many people complain about tracking calories not working for them, and I guarantee it's that they weren't tracking properly.

Edit: Oh another thing: with stuff like protein powder measuring itself in scoops, they tend to be way off in how many grams are in a scoop. I don't know how they get away with it, but if you measure with a scale how many grams are in a scoop, it can be like 25% more than what it says on the tub

We (Americans) didn't understand CICO any better in the past. I'm not saying you're wrong, but the way we get our food has changed dramatically. For the most part, we know what we're supposed to eat. It's just so much easier to eat poorly now. We need to change incentives to make it more costly to eat unhealthy food.

Portion size is very cultural. People from the 50s would be horrified by how large meals have gotten.

Absolutely! There are a ton of cheap and easy ways to get calories these days. In the past we didn't need to worry so much about people understanding CICO.

However, now we have two options:

1. Education

2. Banning a ton of food-types.

Both seem hard at scale, but #1 can be achieved on an individual level, at least.

CICO is probably valid but it's easy to misinterpret. For example, in the presence of insulin, fat and muscle cells take in calories, regardless of the energy state of the rest of the body, resulting in hunger and probably more calories-in. While insulin is elevated, the calories stored wIthin fat cells is inaccessible to the rest of the body … would those calories be considered "in" or "out" according to CICO?

You're the one making it easy to misinterpret by making it massively more complicated than it needs to be. Copy pasting from a previous post of mine:

How to lose weight, by me, someone who has lost 30 pounds and kept it off:

Step 1: Count every calorie you consume. If you don't know the exact amount of a dish, do your best. Apps like MyFitnessPal make this easier.

Step 2: Limit that amount to 1500 calories per day.

Step 3: Weigh yourself everyday first thing in the morning, and only look at 7 day averages at least. Daily fluctuations don't matter.

Step 4: After 2 weeks, see how much you've lost (if any). If you've lost more than 1% of your body weight per week, raise that 1500 number. If you've lost less than 1% per week, lower that 1500 number.

Repeat until satisfied!

How can you make this easier?

1. Eat things that are filling with fewer calories. Think vegetables and protein. Stay away from things that aren't filling and have a lot of calories. Think candy bars. Water helps too.

2. Walk/run. This will burn calories efficiently and if you attach a fit bit to it, you can incorporate the calories burned into your 1500 number above. Weight lifting doesn't burn many calories, though it's nice for your overall health of course.

You're stuck on how fat cells are stored or insulin levels? How is that at all approachable.

Oh I know, I've done basically the same thing and dropped/kept off ~20 pounds. My point is that physiologically it's hard, and by reducing it to just-a-number or just-willpower, it's ignoring very real aspects of life for many people (myself included when I did that).

In technical terms, CICO is a very leaky abstraction.

> In technical terms, CICO is a very leaky abstraction.

I'd call everything else an abstraction. Intermittent fasting and Keto all conform to CICO as an abstraction.

Which is fine and you're right. Calorie counting is the most direct diet but is not for everyone.

> fat and muscle cells take in calories,

They can only do so acutely until the blood sugar drops. It will not matter in the long run if there is a calorie deficit. I like to summarize it like 24 hour calorie balance is far more important than short term acute effects.

I think that's right, but it's worth noting that "until the blood sugar drops" is doing a lot of heavy lifting there. That varies a lot by person. E.g. I wear a CGM, as does a friend. We can eat the same thing, and my friend's CGM reading drops back to his baseline in less than an hour while mine stays elevated for several hours.

I eat low-carb foods and intermittently fast to compensate, but if I ate a "mainstream heatlhy" diet (3 meals a day, grain bowls, etc), my blood sugar would be moderately elevated for most of the time.