"Absent a Medical Condition"?

sheldonklein

I routinely read on these boards that CICO works "absent a medical condition.". Is there such an exception? I'm sure that there are medical conditions that increase appetite or reduce burns, but I don't understand how there can be an exception to CICO.

Mr_Knight

There are no exceptions.

Cherimoose

One example - a digestive disorder where not all calories ingested are absorbed.

annekka

The one I often see people posting about is if they have thyroid issues or PCOS.

KittensMaster

Diabetes wreaks havoc with processing carbs, and then everything else

jgnatca

Diabetes, where fast acting carbs must be watched.

Endocrine disorders.

tincanonastring

In the end, nothing really negates CICO except, as noted, a malabsoption issue. Even diabetes, PCOS, etc. doesn't change the entire equation, just the CO portion to the point where CI has to be adjusted. The "absent a medical condition" statements aren't normally about CICO, but whether or not people should eat certain foods.

Alatariel75

I've always took it to mean that absent a medical condition which requires further dietary adjustments, CICO is all you need to lose weight. CICO works across the board.

senecarr

It depends on how you want to define in and out.
In terms of it being thermodynamic equations, Δenergy(weight) = Q - W where Q is the energy in and W is energy out. To date, no system violates that equation.
Malabsorption issues will really just change what calories go in versus what calories dietary calculations would expect to go in or out.

tincanonastring

senecarr wrote: »

It depends on how you want to define in and out.
In terms of it being thermodynamic equations, Δenergy(weight) = Q - W where Q is the energy in and W is energy out. To date, no system violates that equation.
Malabsorption issues will really just change what calories go in versus what calories dietary calculations would expect to go in or out.

Good point on the malabsorption. Theoretically, though, if someone had such a disorder, would there be any way to know how much to actually put in? I assume such issues are not like a flat percentage of all calories not being absorbed but more likely would be limited to certain macros and/or micros?

senecarr

tincanonastring wrote: »

senecarr wrote: »

It depends on how you want to define in and out.
In terms of it being thermodynamic equations, Δenergy(weight) = Q - W where Q is the energy in and W is energy out. To date, no system violates that equation.
Malabsorption issues will really just change what calories go in versus what calories dietary calculations would expect to go in or out.

Good point on the malabsorption. Theoretically, though, if someone had such a disorder, would there be any way to know how much to actually put in? I assume such issues are not like a flat percentage of all calories not being absorbed but more likely would be limited to certain macros and/or micros?

The exact disorder would probably change how precisely we could predict the change in input, and it would probably require a specialist in a given condition to gauge. I suppose it would always be possible to get someone with the condition to do a metabolic ward study.
To some extent, food labels already do this for the common human condition - protein is not easy to use directly as energy, so while food labels use 4 kCal / gram, protein really probably has something like 5.7 kCal.

piperdown44

My oldest son has Chrohn's disease. There for a while didn't seem to matter how much he ate, he continued to lose weight, not good for an 11 year old. Culminated with a ruptured intestine and removal of 23 inches of intestine. Liquid diet for the next 12 weeks. Even with the liquid diet we were making twice weekly trips to have him weighed so they could adjust the calories.
What I'm getting at is that even doing a metabolic study is only a snapshot in time. With flareups it changes how much is absorbed.

Pawsforme

CICO always works for weight loss when viewed strictly as a thermodynamic equation. If you consume fewer calories than your body burns you will lose weight. Period.

One issue comes in when people have some type of metabolic disorder that negatively affects their BMR. Examples of that would be hypothyroidism or PCOS. If something like that is going on that causes the BMR to be lower than normal it can be extremely difficult to consume less than one burns.

Conversely, you could have some type of malabsorption issue as already mentioned, or something like hyperthyroidism (which raises ones BMR), which would make it harder to gain weight regardless of how much one ate.

ki4eld

CICO works for everyone. Whether a safe caloric level works is based on someone's medical profile. Absent a medical condition, CICO will work just fine. With the medical condition, it may not work at a safe level.

As for malabsorption... nope, you don't know how much you're getting. I have malabsorption from WLS. I have no idea how much of my daily 1003 calories (or every other macro/micro) I'm absorbing. It could be 1002, it could be 100. The goal is 30% malabsorption, but that's an average. Every person will be different. Maintenance will be a lot of fun. /sarcasm

psuLemon

The inherent issue you face, you don't really know what the CO part of the question is. But everyone follows CICO even with a medical issue.

gaelicstorm26

It's always CICO, but for some, knowing your CO is difficult. I have diabetes and hypothyroidism. Double whammy for that tricky CO part. I do the best I can and I have to be patient and realize that I might have to play around with CI if I hit a three-week period of no weight loss. I also realize that keeping up with routine lab work to monitor my blood sugar and TSH/T4/T3 levels is key for my weight loss. When I'm keeping that in check with medication, exercise, and food choices, CICO works well.