There is no doubt that many people struggle to reach and maintain a healthy weight. There are many real and challenging reasons for this. However, unless one basic fact about weight management is fully embraced these real and modifiable reasons will not be the focus of a person’s time and effort, which will negate or significantly reduce their chance for success. The basic fact that I am alluding to is the calorie balance equation, also referred to as calories in versus calories out or CICO. CICO means that bodyweight will change based on amount of calories ingested (more specifically absorbed) versus the amount of calories the body expends (burns). If weight goes up, intake is greater than expenditure. If weight stays the same, then intake and expenditure are matching up. Finally, if weight loss is happening, then intake is less than expenditure. There are a few caveats to CICO, which I will explain in a footnote (1). This should NOT be controversial as there is overwhelming evidence this is how weight regulation works (2). Conversely, there is no quality evidence that this is not how it works. Therefore, if weight is not moving down, then a calorie deficit is not consistently being created. This is what I wish everyone would accept. Regrettably, instead of accepting this is what is happening, there will be a variety of “ideas”(3) that will be used to try to say that they are creating a calorie deficit but it is just not working. Here is what should happen. When weight is not moving down, the first thought  a person should have (if it has been more than a week or two of no change) “I am not consistently creating a calorie deficit and how can I do this consistently”. Losing weight and keeping it off is often challenging, so don’t make it harder by not accepting the fundamental CICO concept. By accepting this you can then focus on the “how to” of consistently creating a calorie deficit.

 

Footnotes

(1)-A few caveats, First, short–term water balance can mask weight loss, however, this can only last for so long, as 3-5lbs of EXTRA fluid will likely go away and/or weight (fat) loss past this amount will show up on the scale. Second, some muscle gain, for most people, 2-5 lbs could happen over a number of months, which could mask some of the fat loss that is happening. However, it is very unlikely, again for most people, for it to mask all the progress with weight loss. For example, if a person is gaining one lb of lean tissue a month (this is very good for most people) and losing 4lbs of fat tissue a month they would still have a net loss of 3 lbs a month. Third, there is a duration aspect to consider. In the short-term, days  or maybe a week or two, even if a person was consistently creating a calorie deficit, at an amount that would likely lead to about 1 lb of fat loss per week, but they happen to also, during that time, be holding onto a bit of extra fluid, then it will not show up. However, when looking at it over weeks and certainly months, a consistent calorie deficit will always result in weight loss. To be clear, none of these factors negate the CICO concept, rather they are things that can temporarily mask it.

(2)-There is some much quality evidence for this concept (CICO) I just don’t understand how it cannot be accepted. Matt and I cover some of it in Chapter 2, a number of sections but specifically the section “If You are Not Losing Weight it is Not Because You are in “Starvation Mode”

http://www.overcomeobesity.org/the-book/chapter-4-weight-loss-101-clarifying-the-basics/

also see the following, which are a few of MANY articles and papers on the topic;

https://jissn.biomedcentral.com/articles/10.1186/s12970-017-0174-y

http://sciencedrivennutrition.com/body-weight/

http://carbsanity.blogspot.com/2011/01/countering-anti-energy-balance-calories.html

http://carbsanity.blogspot.com/2011/06/countering-anti-energy-balance-cico.html

(3)-The “ideas” that CICO is not true is regrettably being put forth by a handful of people, some that have significant influence/reach, such as Gary Taubes and Jonathan Bailor. These authors and others that are health professionals should know better. The evidence does NOT support their position. For the public, I understand that this idea can be enticing; however, it is just not true.

 

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