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