The more there is research into how fat actually works as a tissue the more I suspect CICO is a harmful oversimplification along the lines of just say no to drugs or abstinence-only sex education.
Not just out, both directions can be tricky to measure. It is hard to say for certain how many potential kcal you're consuming are actually absorbed by the body. If you see whole corn kernels in the toilet, those kcal didn't count :)
But yes. CICO is and always has been absolutely true. People are just overly reductive in how they measure both sides, and then claim that CICO is garbage.
In my experience, the most reliable way to understand your body's calorie needs is through consistent measurement:
1. Log everything you eat each day.
2. Weigh yourself first thing the next morning, before eating.
3. Track the trend (did you gain, lose, or maintain?)
Over time, clear patterns emerge. You start to see exactly how your intake maps to weight changes, and you can fine-tune accordingly. It’s not guesswork, it’s feedback.
What surprised me most was how little food I actually needed. Even with regular strength training, a modest surplus was enough to support muscle growth.
Aren't calorie numbers on foods just made up numbers anyway? I'm no expert but I'm pretty sure that a body's method of metabolizing food is not the same as oxygen burning it. They might offer a standardized number, and a basis for comparison, but other than that it's not reflective of anybody's reality.
You need to get orders of magnitude right at first. I find keeping a punned tab with any AI works pretty well. Drop 5 words with every meal or snack and thats it.
It’s ok to assume that you absorb 100% of what you eat, unless you see evidence to the contrary, and no corn kernel poop doesn’t count. Frequent diarrhea, weight loss, skin rash, and basically any symptom of vitamin or mineral deficiency.
>It’s ok to assume that you absorb 100% of what you eat
That's not really true. If you've ever done the keto diet, you know that your body expels unburned ketones through your breath, sweat, and urine. Protein can be used to repair structures rather than burned or stored for energy.
There's also something called the "thermic effect of feeding". Your body requires more energy to process protein (20-30% of calories consumed) than it does carbs (5-10%) than it does fats (0-3%).
There are many ways for food to not be 100% absorbed, which I think can most easily be demonstrated by eating a bag of nuts and waiting a day or two
I don't think it's unreasonable to think that different bodies absorb food in different ways (or proportions), particularly given what we've seen about the gut microbiome
In response to, "but those are rats", I think it's a lot easier to cast doubt on "100% of food is always absorbed" vs "I don't think that always holds true"
I mean, heck: if there are no residual calories in human waste, how can it burn?
My original point: it's ok to assume you absorb 100%.
About the rat thing: the cico hypothesis point of view might look at whether meal timing affecting energy expenditure first, rather than assuming meal timing change digestive absorption.
There is not much point in getting in the weeds about how much you absorb, unless you're running trials on yourself like changing when you eat, or what you eat, and leaving all other things equal like calorie intake and expenditure.
The best dieting strategies I've seen track calories in and weight change. From their you derive calorie expenditure, and it really doesn't matter if you burned it or pooped it out, does it?
It’s not like almonds have x calories for a certain group and y calories for another.
Being wrong about the number of calories in almonds doesn’t count as evidence that skinny people are skinny because they poop out undigested calories.
Also, I’m not saying digestive malabsorption is impossible, just that you shouldn’t assume it unless you have strong evidence to the contrary that doesn’t have another simpler explanation.
CICO is more of an upper bound, but people like to incorrectly use it as a lower bound. Meaning that it's true that you can't burn more calories than you eat, but you can certainly eat many more calories than you store as fat.
(Hell, CICO isn't even valid for something as "simple" as an electric vehicle. My EV's end-to-end efficiency is quite a bit different depending on whether I'm charging from 120V or 240V, the outside temperature at charging time, the outside temperature at driving time, and a handful other factors like state-of-charge. The human body is even more complicated.)
CICO is one of those concepts which is fundamentally correct but can cause so much pain if you follow it religiously and assume all energy sources are the same
CICO works perfectly well. It only causes pain because people are addicted to eating and lie to themselves about how much they actually eat.
Study after study has shown that people who claim to not be able to lose weight via diet simply do not have any idea how many calories they are actually eating.
The oversimplification here is that you're assuming that over-consumption is both completely voluntary and the root cause. But it's not - it's actually a symptom.
People overeat for a variety of extremely complex reasons. Mental health, stress, hormonal interactions. gut microbiome, dopamine deficiency, and on.
The assumption that forcing yourself to eat less is solving the root cause is not sound, in my opinion. If you look at GLP-1 inhibitors, those appear to be a much more root cause solution. Rather than solving over-consumption, they solve the propensity to over-consume, which then solves over-consumption.
What we really need to be looking at is why some people have a propensity to over-consume and why some don't. Why are some people destined to a life of constantly fighting food when others don't have to try at all and they stay thin?
Just intuitive, I know this is also the case for other substances like alcohol. I've never had to struggle with alcohol and I never will. I just drink whenever and never think about it. But for some people, it's a lifelong struggle. They have to constantly be thinking about alcohol, and every time it touches there lips it's a problem. Why? Is it genes? Our environment? Psychological support in childhood?
But the fact people over eat so readily is most likely down to the heavily refined food we eat that our hormones aren’t tuned to handle in my opinion.
I know I was miserable on CICO as Iw as constantly going through cycles of gaining then losing lbs. Whereas once I switched to a whole food diet I no longer even need to think about the calories I eat, I just eat when I’m hungry. And I don’t even crave the cookies and marshmallows at all
You do have me intrigued, what are you general arguments against CICO?
The mechanism from article really does suck, but what does that have to do with CICO? While white adipose cells are created, it's still excess calories that fills those cells.
> You do have me intrigued, what are you general arguments against CICO?
Not the GP, but based on their abstinence-only sex comment I imagine the point being raised is that it's something that is technically true but not a practical guideline.
CICO is a true statement. But you're not going to be able to accurately measure CI and especially not CO. So why bother using that as your guideline on how to proceed? Instead it is known and understood that there are mechanisms for things such as improving CO efficiency, and it's much more practical to focus on that.
You can't outrun your fork (Of course some smart guy will bring up Olympic level athletes, but we're not freaking talking about Olympic level athletes are we?
A 5K run for 30m burns ~300-600 calories. A single serving of a candy bar is ~250 calories. You NEED to restrict the CI portion since its the easiest part of the equation to control.
The typical person who is maligning CICO because it doesn't explain why they're still fat, that person would do much better by better focusing on CICO and performing the all time best exercise for weight loss - the "table push away"
Meanwhile the typical strict advocate of CICO as the end all be all also needs to understand that there's a lot of nuance in both the CI and CO variables.
Shouldn’t you at least have a ballpark correct CI and CO numbers? If you’re doing +1000 calories per day then whatever CO efficiencies you find won’t do anything
Here's one more. CICO ignores the effects of the types of food (CI) and activities (CO) that might make you hungry quicker than others, for example from sugar or fatigue or anything else. Appetite control is very difficult. Those soft factors make it poor guidance as well.
It doesn't though, at the end of the day there's an objective amount of CI and an objective amount of CO. Further, CO isn't just "activities", for instance you burn calories merely by existing. Things you're describing will impact CI and CO, but at the end of the day if one had the ability to fully and 100% accurately measure CI & CO it'd be apparent that the math works.
But this is why "it's just CICO" is at best a tricky phrase. Because the hard part is in the nuance you describe.
I get this over and over on every issue where "math" becomes "guidance". Let me try to bridge by restating:
Math truth is not always good policy guidance.
It is true that CI==CO. It must.
It is not true that telling someone that CI==CO is a good way to get them to manage their weight, because (as mentioned) it's hard to measure and (as I added) even if you measure correctly, you _reduce likelihood of compliance_ by ignoring appetite effects when you call all calories equal.
I think we agree, just trying to find the right words anyway.
CICO is necessary but not sufficient. You also need some strategy for how to achieve CO > CI. Different strategies have vastly different implications in regards to willpower, health outcomes, suffering, time, cost, etc.
CICO is the equivalent of engine tuning, to produce more power you just need to burn more fuel in the same amount of time, easy as a concept but not so easy to achieve sometimes.
In a perfect world where you measure and control everything 100% CICO rules. However, in the real world, different types of food cause variation both on in and out. E.g. some foods promote feeling to satiety and some foods cause some people to overeat. Diet would also affect gut microbiome which affects hormones/mood etc... If you calculate CICO, then it will still be valid. But from the practical diet approach, CICO is oversimplification.
> But from the practical diet approach, CICO is oversimplification.
No, CICO IS the practical diet. Satiety, microbiome, none of that shit matters. All excuses to not properly stick to the diet. You weigh your food, calculate the macros, and that's it. Zero thought required past that.
It is literally impossible to not lose weight even if you are eating nothing but 500 calories of pure corn syrup every day (Though you may feel pretty sick)
Some people can do macro tracking, others don't have the discipline for it. For those people, shifting to foods with a higher satiety to calorie ratio is a better strategy, or intermittent fasting, or cutting out a food group. As you said, what matters is CICO, not how you achieve it.
I like to compare it to programming. If you tell a C++ developer that their software should have good uptime, your advice here is the equivalent of saying "don't have memory leaks, null pointer dereferces or use-after-free". Yes, all true, but everyone know that. What we need are behaviour patterns like RAII, an extensive test suite, running those tests in valgrind/ASAN, etc. that actually help in a forward looking perspective achieve this goal of not making those mistakes which lead to poor performance.
> For those people, shifting to foods with a higher satiety to calorie ratio is a better strategy, or intermittent fasting, or cutting out a food group.
If they can't have the discipline for CICO, why would you give them benefit of the doubt they have the discipline to "follow" the other methods? It makes no sense.
The discipline needed to resist hunger and the discipline needed to stick to a healthy and varied diet is wildly different. The second may require more thought and skill but a lot less willpower.
It does matter in the real world because practically no one is going to adhere to a diet unless care and consideration has been given to things like satiety.
Adherence is way more important than getting pedantic about thermodynamics.
People fail to adhere to diets because its SO EASY TO MAKE EXCUSES.
People can do intermittent fasting all they want, but if they're eating a stick of butter during feeding times, its worthless. Eating to satiety is useless as a marker because satiety is subjective.
Measuring your food does not give you an excuse to cheat, except the person simply choosing not to do it properly. There are no weird ways of getting around the fact that you have a maximum calorie limit, and thats it.
I'm thin. Do you know what I do to maintain that? Fuck all. I eat what I want, when I want. Do I exercise? No.
Why is it that I don't have to try at all, but you do? Shouldn't you be a little curious, a little jealous? How cool would it be if you could maintain what you have now, but without any of the effort?
There's a lot of stuff I don't care about. I don't care about alcohol consumption either. I drink what I want, when I want. And it works out great for me. For others, that plunges them into a life of alcoholism and they die young of cirrhosis. Why? Why does it work that way? Why is it that I can do whatever but other people can't?
These are the questions we should be asking. You're solving the symptom, not the cause here. Eating too much is a symptom. The root cause is the propensity to overeat. I don't have that propensity, so guess what - I never have to try. But why don't I have it? Will I one day get it?
I'm the same way, and I'm pretty sure there's a big part of the "CO" part that differs among people, namely absorption vs excretion. Suffice it to say I think some bodies "hoard" more than others
I lost 150 pounds in 2 years and all I did was eat less, and I kept it off easily. I'm not curious because I saw pictures of myself before I lost weight and I saw the plates of food in front of me and it was absolutely disgusting amounts of food.
I feel sick when I eat large amounts of food and I like to keep it that way, and all it needed was getting used to eating less.
Good for you but most people that do just that rebound a few months/years later. Maybe you already had a good enough diet and reducing sizes did it for you but most people require a change in their diet for it to stick. Keeping yourself thin on a highly caloric fast food diet is always harder and if you are already obese you most likely have a problem with food too.
I don't have to try at all, you had to try a little, and some people have to try a lot. And that's why we're seeing a variety of experiences with obesity.
The difference is, I recognize there must be something about my genetics, or my way of life, or my upbringing, or whatever, that gives me such privilege. You, however, have zero humility, and simply believe yourself superior. I doubt it works that way.
I mean, I have plenty of other problems. I have no discipline, no self control. And I'm thin. So... it's more complicated then you give it credit.
I actually said that CICO works if you control everything and weigh your food and calculate the macros. It may work for you, it works for bodybuilders, but this approach is not necessarily the best. All diets work though reducing calories. Dietary adherence is much more important. Most people are not going to obsessively weigh all their meals. And if you feel sick or hungry all the time, you are much more likely to break the diet.
So, I maintain that, yes, CICO works and calories + macros is the most important. But unless you control intake 100%, then the types of food you consume affect how much you eat, energy levels and compliance. This is especially true long term (over 5 years).
"None of that shit matters" in purely thermodynamic sense, but it matters immensely to the actual goal of getting people to be healthier by having less body fat. In that sense, CICO is an oversimplification.
I personally don't think that anyone without enough will power and discomfort tolerance to feel hungry for long periods of time when surrounded by limitless food should be forced to live a shorter more painful life.
The key to getting people to quit smoking is for them to stop smoking. Very simple. Why on earth do we have nicotine gum and patches?
CICO is an oversimplification that generally assumes that "all calories are equal" on both sides of the equation. On the one side it assumes uniform density of energy in foods and is based on a lot of rough estimates from burning foods in ovens. On the other side, most of our concepts of how much calories we "burn" in a day or given activity and how we use those calories in the complex biology of our bodies is not very far divorced from "assume the body is an ideal spherical furnace" based a lot on CO2 exhaled and temperatures raised. It is a greatly over-simplifying model on both sides of the equation.
Of course, greatly over-simplified models are still useful. CICO as a useful first approximation of a diet still has its uses and its places where it is more useful than some alternative models.
I think food calories and the way we talk about them (like food "contains" them, always burning them) feel a lot to me like the last bastion of Phlogiston Theory in any of the sciences. Chemistry has moved away from the "Calorie" as an approved unit of measure for the more accurate/more reliable "Joule", but also to remove some ties to old Phlogiston baggage.
I think most people would laugh at this idea pushed to its current Physics extreme that food should be measured in Joules by Relativity's infamous E = mc^2 mass-to-energy conversion ratio and that we should assume that the human body is some efficiency percentage of an ideal spherical fusion reactor. Joules In/Joules Out, right?. Why does it sound more accurate to so many as a model when it is "heat particles"/Calories?
(Which again, isn't a call to entirely toss the model, it serves many as a first approximation well enough. But it seems past time to develop better, more targeted models.)
It's an oversimplification of how the body works to the point of not being useful. For example, if you eat 2500 kcal a day and maintain a steady weight of 150 lbs, it is not the case that if you change your diet to 2200 kcal you will consistently lose X pounds per week. You would more likely lose a bit, then plateau at some level that's hard to predict, because now your body adapted to an input of 2200 kcal a day. Add to this the complication that where those calories come from matters a lot, because when you increase your blood sugar, your body increases insulin which builds up body fat, but if you have eat a low-sugar/carb diet, that happens less. And if you eat sugary foods, you will tend to get hungry more quickly than eating protein-based foods. It's all so person-dependent and food-dependent that just saying "eat less calories and you'll lose weight" does not accurately describe most people's reality.
Your example is the oversimplification that causes people to disbelieve CICO. In your example the body adjusted and the CO wasn't stable. CICO still holds, the flaw is the person assuming their CO was stable.
People who staunchly support CICO as the end all be all talking point miss what you describe. At the same time people who decry CICO as being bogus are missing what I describe. Both are true and both are wrong. It's really just a semantic argument.
If you dropped your calories you wouldn’t expect to loose weight forever, you would expect to loose a bit of weight while your body adapted and then stay at that new weight if you stay at the new lower calories. CICO works well for the vast majority of people, it’s just very hard to know what the balance is and the averaging window is weeks not days.
CICO is same as when talking about personal finances and distilling it to earn more than you spend. Absolutely truthful statement, but pretty hard very often in practise... And don't really consider many finer points.
> As Clotaire Rapaille wrote in his terrific book, The Culture Code,
“Years ago, Tufts University invited me to lecture during a symposium on obesity.
Lecturer after lecturer offered solutions for America’s obesity problem, all of which revolved around education. Americans would be thinner if only they knew about good nutrition and the benefits of exercise, they told us. Slimming down the entire country was possible through an aggressive public awareness campaign.
When it was my turn to speak, I couldn’t help beginning with an observation.
“I think it is fascinating that the other speakers today have suggested that education is the answer to our country’s obesity problem,” I said. I slowly gestured around the room.
“If education is the answer, then why hasn’t it helped more of you?”
There were audible gasps in the auditorium when I said this, quite a few snickers, and five times as many sneers. Unsurprisingly, Tufts never invited me to lecture again.”
People say it because there are all sorts of alternative theories, such as "setpoint theory" that say* that your weight is nothing to do with what you eat.
I think 1 in 36 kids having autism is similar to how breast cancer diagnosis shot up when we had better imaging ability or when we figured out prostate cancer was actually fairly common in older men but not usually something worth doing anything about. When we merged in aspergers and autism together that obviously makes autism rates higher and as research continues on diagnosing autism it makes sense rates increase from there too? I mean in the past we thought autism was only common in boys!
I sincerely hope this is the explanation and I will be frustrated if this information is not presented as a percentage of the increase as part of the report. If it fully explains the increase, even better.
I agree that I’m frustrated that this isn’t being coveted. Asperger’s being moved into autism was huge news at the time, so idk how RFK missed something so obvious and is pointing to quackery like vaccines. I don’t understand how we got to the point where cranks are trying to to prove their assumptions instead of real scientists.
It's pretty much impossible to control for, because you don't know what you don't know. Meaning, you can't estimate how many people haven't been diagnosed in the past because, well, they weren't being diagnosed.
