There seem to be two main camps around the whole calorie issue:
- The calories in vs calories out camp based on the first law of thermodynamics: change in weight = energy consumed – energy expended. If calories in exceeds calories out, you will gain weight. If calories out exceeds calories in, you will lose weight.
- The hormone camp. If your hormones aren’t balanced, changing your calorie intake won’t do a thing, and might make things worse.
A calorie of meat may be the same as a calorie of bread in a closed system, but what happens when you put these foods into a complex human body?
For the purposes of this blog post, I am going to focus on weight loss rather than weight gain since, in my practice, I primarily see patients struggling with overweight and obesity, and much less so with the desire to gain weight, but the idea is the same.
As we see in diseases like anorexia, if you don’t take in energy, you lose weight. On the TV show Survivor, where contestants eat a restrictive diet of mainly rice, they almost all show some weight loss by the end.
Obviously the above scenarios are undesirable to be in, but it certainly acts as an example that less food = weight loss.
Even at a less extreme level though, it’s not so easy for many people to achieve weight loss following this premise. If weight loss is all about simply reducing your calories, then why are some people still GAINING weight after months of appropriate dieting and exercise?
The hormonal theory of weight loss
A 2015 study looking at over 175,000 men and women found that the probability of losing weight by eating less and exercising more after 9 years was 0.6%1. A 99.4% failure rate. What’s up with that?
What’s important to understand is that the amount of calories burned DEPENDS on the amount of calories consumed2. When we restrict calories, our metabolism slows down to reduce caloric output (calorie burning).
Not only that, but we eat more later to compensate3. Not just over the course of one day, but over weeks and months. The hormones driving hunger are too strong to resist as they try to maintain our metabolism set point. This is why the longer you are overweight, the harder it is to maintain weight loss- your metabolism is so used to that set point.
If you manage to hang in there with your restrictive diet for a long time, you may lose weight in the beginning, but once your metabolism slows down, you will plateau. The real kicker is that this reduced metabolism may continue on for a long time even when you increase your calories back up, which means you might gain weight on the amount of calories that was previously maintaining your weight4.
Do you even really want the same results as the examples I gave above? Think about what those people went through to lose that weight, think about how these people FEEL on a daily basis. Of course those are extreme examples, but chronic dieters often feel deprived, hungry all the time, tired, irritable, and cold.
What about the kind of calories you restrict?
You might have heard of the professor who went on a reduced-calorie, mostly Twinkie and baked goods diet for 10 weeks in an effort to prove that calories are all that matters for weight loss. He lost 27 pounds. Not only that, his body fat percentage went down and his cholesterol markers improved. Seems great right?
From my perspective, this was simply a starvation diet, considering he limited himself to a total of 1,800 calories a day. A man of his size and weight would normally consume 2,600 calories per day. Also, 10 weeks is nowhere near enough time to measure the true effects of the diet on health. There’s also no mention of other markers of health such as how he felt…energy, mood, digestion, headaches, sleep, skin issues, satiety? He didn’t continue the diet if that tells you something about sustainability.
Hacking the code
There are many variables that cause different rates of fat storage and affect how much we want to eat. So yes, technically, calories matter, but for many, simply eating less and moving more does not work. We need to instead hack the metabolic processes that affect our appetite and fat storage:
- the effect of the different macronutrients (fat, carbs, and protein) on fat storage
- the effect of our many hormones that affect fat storage such as: thyroid hormone, cortisol, estrogen, progesterone, testosterone, growth hormone, insulin, and more
- the health of your gut microbiome
- your digestion and detoxification processes
- your sleep
- how often you eat, i.e. intermittent fasting (FYI: intermittent fasting does not always = calorie reduction)
- your genetics
THESE are the things that we should be focusing on, NOT calorie counting.
Where to go from here? If you don’t know which of the above areas need work to start to improve your body composition, I highly recommend working with a naturopathic doctor (like me!) or a functional medicine doctor who can help direct you. They can support you in tweaking your diet so that it is supportive of your goals, AND sustainable. They can also provide you with in-depth testing to get to the root of your resistant weight loss.
1. Fildes A, et al. Probability of an Obese Person Attaining Normal Body Weight: Cohort Study Using Electronic Health Records. Am J Public Health. 2015 Sep;105(9):e54-9. doi: 10.2105/AJPH.2015.302773. Epub 2015 Jul 16.
2. Labadaum U et al. Obesity, abdominal obesity, physical activity, and caloric intake in US adults: 1988 to 2010. AN J Med. 2014 Aug; 127(8):717-27.
3. Suminthran P. Long-term persistence of hormonal adaptations to weight loss. N Engl J Med. 2011 Oct 27; 365(17):1597-604.
4. Rosenbaum et al. Long-term persistence of adaptive thermogenesis in subjects who have maintained a reduced body weight. Am J Clin Nutr. 2008 Oct; 88(4):906-12.