I hate to use the old correlation is not causation....

But even if the virus does “cause” obesity, is it causing obesity by slowing down the host’s metabolism (decreasing the calories out) or increasing appetite (increasing calories in)?

I'm not sure how I could have made that any clearer. I included (show correlation) specifically for that very reason.

But not causation and still didn’t explain whether that could be explained by the standard CICO equation.

CICO is a copout. Calories in is relatively simple. Calories out is hideously complex. When people describe weird things that metabolism does, real or fake, they're things that shift the Calories Out numbers way beyond the simple results you get from body composition and exercise level.

There are so many separate ways for calories to go "out", too.

So it gets used in this unfair double-standard way, where managing weight is "just CICO", as if it's a handful of inputs into a one-line equation, but if someone argues against that, saying it's more complex, then the natural response is "well actually CICO includes every single complication you've mentioned, so you're wrong to object".

It is just CICO, whether you won the genetic lottery that makes the calculation simpler or not doesn't mean it's any less of a cop out than saying that it would be simpler for me to be a great basketball player if I were 6 foot 8 instead of 5 foot 5.

Something can be both true and used in a misleading manner.

To use your same metaphor, there are people going around speaking as if height and total hours of training are the only things that matter for basketball skill.

Understand that there are necessary and sufficient conditions. A sufficient condition for obesity is too high chronic caloric intake. A necessary condition is retention of this surplus. Some people will feel correctly full when they overeat high calorie foods, others only if volume is too big, yet others have the distended stomach where even that does not work. Some have hormonal deficit that makes them retain more (e.g. hypothyroidism) or counters satiety signaling. Others have very wasteful metabolism or digestion where less is retained. Some really do highly strenuous activities that just demand more energy.

Ultimately you set a caloric target with a carefully constructed diet and watch the long term weight slope over months. That's the science of it. Even high fat ad lib diets ultimately resulted in caloric input restriction, stronger than other diets they tried. (see Cambridge study)

> Ultimately you set a caloric target with a carefully constructed diet and watch the long term weight slope over months. That's the science of it. Even high fat ad lib diets ultimately resulted in caloric input restriction, stronger than other diets they tried. (see Cambridge study)

Agreed, but I'd characterize all that as focusing on the "Calories In" part. That's complicated enough itself, and avoids implying that the entire situation is some trivial function.

> Calories in is relatively simple.

There are at least two categories of issues that make calories in not so simple: eating disorders and malabsorption disorders.

You might try clicking the link I provided. The Wikipedia page details the virus and provides links to other sources one of which was conducted on chickens where they measure input/output and still saw positive weight gain.

So exactly how do you explain mass just coming out of nowhere?

I think all berdon is trying to say by "not simple physics" is that even though CICO is true, it's not helpful to people trying to lose weight because there are many other conditions (e.g. a virus) that can affect the body's metabolism - to a limited extent. This particular virus seems to make you fatter even on a precise calorie controlled diet, which implies it must reduce your metabolism.

For the record I disagree with this - I think CICO is a helpful way to think about weight loss, because it implies that if you aren't losing weight on a calorie controlled diet, you simply haven't cut enough. (Though serious problems might be indicative of some medical condition, in which case you should consult a doctor to see if it can be alleviated to make CICO easier.)

CO may be difficult for a person to manipulate, and raising CI to put on weight may be physically difficult, expensive, or ineffective. However, reducing CI takes willpower but will make you lose weight. If you reduce it enough. Somebody may have a CO so low that the reduction in CI required to lose weight might require medical supervision (e.g. to prevent malnutrition.) That's probably not the case for most people though; certainly not people like myself. If I mustered the willpower to eat less, I would doubtlessly lose weight.

If I were to fall for some of the new-age mumble jumble about weight being some innate genetic trait like iris color, I'd think myself helpless. If I were such a person, being informed of CICO would doubtlessly improve my life.

> However, reducing CI takes willpower but will make you lose weight. If you reduce it enough. Somebody may have a CO so low that the reduction in CI required to lose weight might require medical supervision (e.g. to prevent malnutrition.) That's probably not the case for most people though; certainly not people like myself.

Yes, this is exactly my point. I'm simply giving a measured defense of what berdon has been saying further up this thread: CO is not a known constant and may vary based on certain medical conditions. Because of this, CICO can sometimes (I think berdon would say frequently) be unhelpful advice to someone trying to lose weight, because they struggle with cutting CI far enough to lose weight, which may be due to a person's health and biological makeup.

Then I think berdon's concerns are misprioritized. It's very rare for the necessary reduction in CI to require medical supervision. The overwhelming majority of obese people in America are eating more than is reasonable to eat, and a reduction in consumption would improve their lives considerably with no real risk of malnutrition occurring.

By focusing on obscure edge-cases, all we're really doing is to make it easier for people in the common case to rationalize away their situation. That's very common. There are more voluntary overeaters who claim they have an involuntary obesity-inducing disorder than there are people who actually have such disorders. I've got a whole family full of them. A big bowl of ice cream after every meal is a choice, not a genetic condition.

Partialrecall - my concerns are my own but the point I was attempting to make has nothing to do with what you're talking about. All of which I agree.

My point is the body is very complex and any attempt to simplify it is doing a disservice to anyone listening to you.

I was overweight for 20 years and lost the weight by calorie reduction. It works - clearly. But in a forum reserved for educational discussion I'm not OK glossing over the complexity of the body because it's true in the general case. That'd be as sinful as saying quantum physics is wrong because newtonian is generally the deciding set of rules.

Nobody is glossing over it, it is subject of active research. Until that research produces any generally useful results (drugs, tests, treatments), the advice stays the same.

We know exactly one applicable test: thyroid hormone levels. This one is worth checking.

Eat less everything but more fresh vegetables, especially greens, exercise more. How much depends on how fat you are - not necessarily just overweight, body composition and fat percentage is more important and still reliably measurable.

"Toffee" kind of fat is a thing, where a thin looking and not very heavy person is actually fat inside, just lost muscle so weight stayed similar.

On the other hand, nobody wants people with big muscle mass to always cut diet to levels expected of show body builders.

> Empirical

I think the word you’re looking for is “anecdotal”.

No one here knows anything about your TDEE so it shouldn’t be surprising to anyone that you could lose weight on 3500 calories/day. If your TDEE is >3500, then yeah, weight loss. Especially since the thermic effect of food is quite high for protein, and that people suck at accurately recording or even measuring their actual intake.

I addressed your concerns over my TDEE by stating both instances occurred under the same level of activity and general conditions. In both instances, I lost about the same amount of weight weekly as well. I've also been counting calories for longer than 10 years and at that time I had a spreadsheet with such granular detail I could track the average duration and quantity of protein still within my gut based on average timing, etc.

...

Actually...empirical works as well. I think anecdotal is just the latest trend.

Empirical

based on, concerned with, or verifiable by observation or experience rather than theory or pure logic. "they provided considerable empirical evidence to support their argument"

You didn’t originally say that you lost weight at the same rate, making your statement almost meaningless. Now that you’ve added that statement, I honestly just don’t believe your assessment. This isn’t a judgement call and I’m not questioning your truthfulness. I simply think your observation was either biased, incomplete, or insufficient.

My gut says you did this for too short of a period of time for the results to be meaningful, or else that you’ve left out something meaningful, or that you simply didn’t accurately measure your caloric intake. If you were losing weight on 3500 calories/day, then your TDEE was north of 3500. If you dropped to 900 calories, you’d be in a 2600 calorie/day deficit without even accounting for whatever deficit you were in initially. I don’t care if that was all HFCS, you’d be losing over 5 pounds a week. That’s major weight loss and I don’t believe you saw the same weight loss at 3500 calories and 900 calories for an extended period of time. It simply doesn’t work from a physical standpoint.

“Empirical” to me implies a level of data that you don’t get from a singular anecdote.

You're right, I didn't say I lost weight at the same rate. Oh well.

Cool? It seems you're mostly interested in your own opinions - both with regards to my empirical evidence and your connotation of the word. I'm not interested in either.

Also, your analysis of my losing weight on 3500 calories requiring my TDEE to be >3500 is drastically marred by your clear assumption that a calorie = a calorie. You're incapable of accepting anything that doesn't fall into line with that assumption. Strong bias.

Please provide any evidence that a carb calorie counts for nearly 4 protein calories and I’ll take your anecdote a lot more seriously. You’re making an extraordinary claim with no evidence. Why would I accept your anecdote over my “assumption” that dietary scientists weren’t all completely incompetent when they agreed that a calorie is roughly a calorie? How is it that you calculated a 4:1 conversion and everyone with an actual lab doesn’t?

If you told me that one time your car got 120 mpg because you switched to premium fuel, I’d likewise not believe you. I’m much more likely to think your gauge is faulty or you misread your actual results.

As much as you might want your personal anecdote to be compelling, it just isn’t. I’m not going to give your anecdote the same weight that I give the broad scientific consensus.

I want to expand a little bit more: The body can be simplified down into an input/output black-box - almost like a thevenin equivalent. But most people unaccount for lost energy in the output. No two bodies are alike and no two bodies share the same efficiency in breaking down food, absorption, conversion, and excretion.

Yes, you can collect the excrement and analyze the output. But that analysis doesn't tell you much. You don't know how efficient the black body is so you don't know how much of the waste could have been utilized or not. Not only that, you don't know if the body's efficiency is static or dynamic based on inputs and outputs.

You're describing difficulties with precise measurement of inputs and outputs, but I don't think the difficulty of making those measurements refutes the core idea of CICO at all.

The difficulty of actually implementing CICO suggests we should have sympathy for those who fail. This doesn't refute CICO.

I don't think anyone disputes the laws of thermodynamics, just how the body processes different macronutrients in the presence of certain levels of hormones. By changing those hormones, you change the balance of the total energy equation. For example, I know someone with crohns disease, and her body just doesn't metabolize nutrients the same way mine does. I burn a donut more efficiently than she does. In this case it isn't about hormones, but about inflammation, but it's generally the same concept just on a more apparent scale.

Your strawman is implying I was trying to refute CICO. I never said that - I said people don't count all the outputs.

It was not my intention to strawman you. I apologize for misreading your intent.

Don't apologize. Regardless of his intent, he claimed

"I've lost weight eating 900 calories/day and I've lost weight eating 3500 calories/day with the same level of exercise. The difference was the 900 were carbs, the 3500 was >90% protein"

And if you're not trying to refute CICO, you better make damn clear that even though you're ingesting 3500 calories, you're essentially just crapping out most of it because our bodies can't process that much protein at once.

Wording is hard.

I've tracked calories for >10 years and macros for >5 years. And, at the time I spoke about, I was taking in protein continuously and meticulously tracking ingestion rate and time and estimating digested and excreted protein levels. But, even still, obviously I was shitting out most of it.

I actually do believe and advocate for CICO for most people. But I reject notions that anything related to the body is black, white, or simple and hold strongly to them as convictions. I tried to provide examples to those points with the last as an example that the C in CICO is a sneaky misnomer and better served as being an E. It's just that in the general case for most people E averages into C.

I do agree with you on the apology - it's the internet, no one expects an apology and if you do you're insane. Furthermore, I wasn't offended and was only pointing out the rhetorical tactic being employed.

It's super rare though that anyone in the world not on a special diet consumes this much protein. That's really hard, volumetrically, as protein is calorie sparse. Which is why it's useful for dieting, to keep volume and water in while keeping caloric content low. (With potential side benefits for satiety.)

CICO is mostly nonsense, because you can't control neither CI no CO.

CI is based what people eat, but how much and how often people eat (if you don't expect perfect and infinite willpower) is based on how hungry they are, and that is hormonally controlled, based on complex feedback loop that includes insulin levels (so what you eat and how often) and activity levels.

CO includes many things you have no conscious control over, like heating (ever stopped being cold after a meal?), muscle repair and buildup, brain, etc. Only small fraction of that is exercise.

People saying "it's just CICO" are as disgusting as millionaires saying "just stop being poor, it's easy, you have to make more than you use" while knowing nothing (and not caring) about student loans, healthcare costs for non-insured people, housing crisis or anti-labor practices that suppress wages.

> CICO is mostly nonsense, because you can't control neither CI no CO.

This is a wholesale abdication of responsibility and an embrace of victimhood.

Yes, there are elements of calories out that aren’t fully in your control. However these place a lower bound on calories out. You can absolutely increase your exercise and activity level.

On the other side, you are very much in control of your calories in. You can choose to eat a better diet (e.g. whole foods) that makes it easier to maintain a caloric deficit. You can choose to stop eating before full satiety. You can even go so far as to fast, cutting your calories in to 0. Obviously hunger matters but this idea that you can’t control your eating at all because you’re hungry is ridiculous.

You are very much in control of these factors. Yes, there are broad issues contributing to obesity but individuals are not relieved of their responsibility just because society also has problems.

> You can absolutely increase your exercise and activity level.

Exercise is important for health. Exercise does not help people control weight, and it may make people heavier.

The fact that people insist they're scientific while ignoring the evidence is particularly frustrating.

This is both scientifically untrue and longitudinally true.

Of course if you use exercise to help create a calorie deficit you will lose weight. However, every single study shows that most people won’t lose weight by exercising. They overestimate how much they burn and underestimate how much they lose eat. Exercise also tends to make you hungrier and it makes it harder to not eat more. Also, hardly anyone has the discipline to work out consistently over a long period of time or the fitness level to work out long enough and have enough to use exercise as a weight loss tool.

You appear to be agreeing with me?

I’m saying it’s more nuanced. Anecdotally, I spent a decade keeping weight off by exercising 10+ hours a week as a part time fitness instructor and training for runs. Even now I lose weight by exercising. But most people aren’t going to work out at the consistency and intensity that I do. It takes more discipline for me not to workout too much.

Gaining weight even when calorie controlled due to exercise is possible, but you will lose fat percentage while gaining muscle mass thus increasing base metabolic rate. Doubly good.

Which is why you should get one of the approximate fat percentage meters. (Clamp better than electric but less convenient.) And maybe run a DEXA or volumetric body composition scan sometimes.

Another good easy measure is the belt size, for obese people. Smaller is better. Or waist/hip ratio. Requires a tape measure, that's it.

If you exercise and weight stays the same but belt size goes down, you're on the right track.

Exercise can absolutely contribute to weight loss. It does not guarantee weight loss because an individual can always eat more than they burn (and indeed many do). That doesn’t mean it’s not a very useful tool for weight loss in a continued caloric deficit.

Maintain your caloric intake level “at maintenance” and add 5 miles of running per day and you’ll lose weight.

> Exercise can absolutely contribute to weight loss

That's not what the evidence says.

You’re clearly speaking in generalities because the evidence is absolutely there that people can lose weight by exercising. But if you’re speaking in generalities then people basically don’t lose weight at all. The studies indicate that nearly no one keeps weight off long term.

If you restrict your sample to the select few that do keep off the weight, some do it with diet alone. Some do it with diet and exercise. Some very few do it with exercise alone. Any of these strategies can work. But in general, none of them do.

That’s not what studies show. Studies show that most people can not lose weight by exercise alone:

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3925973/

Scientifically it is possible, but that’s not backed up by how humans actually behave.

Sorry, is there something specific in that article that supports your claim, because I’m skimming over it and seeing lots of stuff that supports the assertion that people do indeed lose weight from exercise, that it generally requires a relatively high amount of exercise, but that it varies a lot between individuals.

> Overall, the changes in weight in response to ET without caloric restriction are highly heterogeneous and individual differences can span weight gain to clinically significant weight loss.

> Supervised ET studies which have demonstrated clinically significant weight loss with aerobic ET (without caloric restriction) have far exceeded the minimum levels of physical activity according to public health definitions. Ross et al. observed an 8% weight loss in obese men after 12 weeks of aerobic ET with no alterations in dietary habits(daily exercise sessions of 700 kcals). In a different study, Ross et al. observed an 6.8% weight loss in premenopausal women (BMI>27) following 14 weeks of aerobic ET with an energy expenditure of 500 kcals per session. In the Midwest Exercise Trial, Donnelly et al. (n=131) observed a 5.3% weight loss in men after 16 weeks of aerobic ET at approximately 2,000 kcals per week. In contrast, the women in the exercise group did not have a significant change in weight (0.7 kg) following the intervention, but the exercise program prevented the weight gain observed in the control group (2.9 kg.) Thus, clinically significant weight loss is possible with aerobic ET without caloric restriction, but it requires a high ET volume. For the general population, these ET volumes may not be practical or sustainable.

In general, weight loss intervention doesn’t work well. Most people fail to lose significant weight, to adhere for an extended time, or to keep the weight off for years. This is the case no matter how the weight loss is achieved. Even gastric bypass patients often manage to gain back enough weight to get back to the obese mark. That doesn’t mean weight loss is impossible, but it is definitely hard. Exercise is absolutely a way to lose weight, but you have to be serious about it and do considerably more than the minimum recommendation, or you have to restrict calories, or preferably both. And you have to somehow maintain long term if you don’t want to immediately gain it back.

The evidence doesn’t say it’s not possible. If we were all homo logicus exercised consistently and kept our caloric intake in equilibrium to our BMR and added exercise on top of it, it can be done. But it doesn’t work in practice for most people.

Yes you can both control what you eat and how much you burn. In my heyday when between teaching fitness classes and training for runs, I was burning conservatively 5000 to 7000 calories a week, eating like a horse, and not gaining weight for over a decade.

After I stopped working out but didn’t cut back what I was eating enough, I gained 40 pounds over the next three years - and that’s a lot when you’re short.

The last two years, I’ve adjusted my calories in (brought them down) and my calories out - about 3000-4000 a week and I’m back down to about 5 pounds above my fitness heyday weight.

But, I would never tell anyone else the best way to lose weight is via exercise. Studies show that hardly ever works because people overestimate how much they burn exercising and underestimate how much they eat. Also in my experience, people statistically never get to the point where they exercise long enough, hard enough or consistently enough to lose weight. I would always tell people to focus on their diet and tell them to talk to a dietitian if they wanted to lose weight.

Wow, that's extremely judgemental. When I was on the swim team in highschool, I was fit as a fiddle. When I went to university I chose to stop swimming but also chose to continue eating the same (because I like food.) Predictably, I started to get fat. I'm certainly capable of eating less, and I am also capable of increasing my activity. Your rant denies that I have any agency in this matter, which is somewhat offensive.

And even if it were the case that I had no agency, it would still be the case that my weight loss was due to a CICO imbalance. CICO is a matter of physics, not ethics or morality.