Do you believe in strictly Calories In - Calories Out?

lindsey1979

Okay, then how do isocaloric diets (with the same caloric deficits) result in different weight loss? If it's all CICO, then the macros shouldn't matter and the results should be the same.

Because the measured calorie expenditure, hence deficit, can only ever be an approximation. Lots of different factors are going to affect expenditure, which will lead to absorption of energy by the body to be less than forecast, far fewer lead to it being greater than forecast.

The key point in your statement is different weight loss, yet upthread we've got people claiming a significant deficit yet gaining weight. Not going to happen, unless they're storing solar energy and wind power.

Sure, but mathematically, you can imagine a scenario with the right numbers manipulation where someone could gain or stay the same whereas another lost -- you'd just have to shift the bar for the calculated deficit closer to maintenance.

But different weight loss is the whole point. If all calories were created equal and quantity was the ONLY thing that matter, then the results would be the same. Since they are different, there is another factor(s) at play that are not accounted for in sheer caloric value.

This is still just variables in the CO portion. It does not negate the fact that you need to be in a caloric deficit to lose fat.

Once again, not my point. I'm not saying that you don't need to be in a caloric deficit, but how you manipulate that deficit will make a difference in your weight loss. So, it's not all about sheer caloric value -- otherwise, results wouldn't differ, and they do.

Am I not saying this clearly?

I think I have pretty much understood what you are saying (and generally do not disagree) - however, in a thread where some people try to indicate that you can gain weight on a deficit, I think it important to make the point that it is not what you are saying.

Also, I wanted to make it clear that results differ mainly when you look at people with metabolic issues. When you look at populations when they do not have them (and even in conflicting studies where they do to be honest), then results do not differ significantly.

I agree that people who think CICO is totally invalid are way off, so I totally agree with you wanting to dispel that notion. But, on the flipside, there are a LOT more people that I've seen that say CICO is the ONLY thing. And I'd like to dispel that notion as well.

As I said before, I think they're both important parts of the weight loss puzzle for people.

Both important, but all calories are not equal how they effect blood sugar and uptake.

Are you kidding me right now?! Did you just say that you agree that CICO is important for weight loss, while macro counts are important for optimal health?

Because that is what EVERYONE in this thread has been saying.

I think it might just come down to her reading comprehension being way off and she thinks we are saying something we aren't.

Going to make this very clear. CICO is all that matters for weight loss specifically. For health and for nutrition and for wellbeing yes of course what you eat matters. What you eat matters for weight loss in the sense that to sustain weight loss you have to sustain your health so to have a sustainable diet for weight loss then yes what you eat matters...but not because CICO is incorrect.

And this is what I think is silly -- this decoupling of the amorphous "good for your health" and weight loss. They're linked. One will affect the other, either in how much fat versus muscle you lose, overall lbs lost, how you feel, how you sleep, how your hormones adjust, how manageable the program is for you, etc. -- that will all affect your ultimate weight loss and body composition goals. To pretend that they're totally different things to me is an issue of not being able to see the forest for the trees.

Yes...and no one disagrees with that, or at least I have yet to meet someone who disagrees with that. We all agree that having a healthy diet is important for sustained weight loss right? Anyone disagree with that?

Here is the thing though, that is not an invalidation of CICO. CICO is still applicable and is still true.

Once again, not an invalidation issue. I don't know why you keep repeating this after I've said the contrary more than 5 times. It's like you just keep setting up false arguments against which to argue.

Because that was Gina's claim. I never said it was your claim. I was talking about why Gina was incorrect in using this as an invalidation of CICO. I was not referring to your comments at all. That is what I meant by "her reading comprehension"....I was referring to Gina, not you.

Oh. Well, you replied to my quote, so that's why I thought it was directed at me. My apologies.

lindsey1979

Yes, CI can be affected by obtuse factors like excretion and poor metabolism, but it will never become a larger amount of energy than it contains.

That's really poorly worded but my head hurts so screw it :P

And that's really the point - factors can and do affect both CI and CO, but at the end of the day if CI is less* than CO weightloss WILL occur.


*scientifically, not just assumed to be

None of the rest of this discussion invalidates that.

True, but if you can't really determine the numbers, then you have to do more to cover that margin of error. And regardless of that, isnt' everyone interested in figuring out the most effective way that works for them? If lowering or raising their carbs, depending on the individual, results in greater, more effective results, doesn't everyone want to know that?

Doesn't everyone want to maximize their efforts? Get the most bang for their buck? And, isn't finding the most effective way what will lead to the most sustainable longterm changes?

You would think so! I know for a fact that when my anxiety level goes up, I crave carbs. I also know in order for me to lose the weight I did, I had to reduce my carbs by 10% of the MFP default. So, it doesn't matter what anyone says about CICO or eat what ever carbs you want, I know I need to keep my carbs on the lower side. Others can eat a steady diet of carbs and still lose weight. I can't. These very same people may find after losing their desired weight that they may have to adjust their carbs to maintain or perhaps they will be able to keep the same ratio. At any rate you can't paint all with the same paint brush which is what CICO is doing to some degree.

Are you saying that if you had kept your carbs relatively higher but decreased your calories from protein and/or fat substantially, you wouldn't have lost weight?

If so, I'm once again back to doubting that you truly understand CICO.

Yes, or a lot less weight for the same caloric deficit. Anyone with insulin resistance is sadly very familiar with this. Some use medication, but many have to use low carb as well as medication.

That was the point of that whole study.

jofjltncb6

Gotta read inside of the quotes.

(Has anyone else given thought to whether or not it's a violation of the "spam" section of the Community Guidelines (all hail!) to constantly quote existing posts without adding anything to them? No? Just me? Oh. Well, carry on then...)

ISWYDT!

Hi jof

And it makes me twitchy.


*twitch*

jakichan

And while all of those are legitimate points, you can still simplify the equation to CICO when dieting down and be successful doing it. I believe that is what gets lost in all of these discussions. No one is saying that different macros have different affects on body composition, or even to a much lesser degree, weight loss (given the TEoF), and of course on health. The point is that by simply measuring your intake and output, measuring where you can, and sticking with it you will lose weight because CICO will hold. The rest, while they make interesting reading, are easily lost in the noise of inaccurate measuring and estimation of exercise calories.

I would agree - I'm just saying that the tools to measure as such DO NOT EXIST. Or at least are not practical. Some reasons:

1. Our bodies adapt. You're NEVER measuring "calories out", you're guessing. If you've been dieting for a while your BMR is probably lower than you think it is. Are you SURE what your BMR is today? I think a lot of people who get frustrated are frustrated because the true amount of calories they get out of their food is a total guess, and the true amount they expend is a total guess.

2. "Water weight". I mean it does happen. If I stop exercising for a week I pee a bunch. And I drop a bunch of weight.

There's other weird stuff that goes on. So I'm convinced that an energy deficit can cause weight loss, but I also know that our bodies can do strange things, like lower your metabolism to compensate for trying to create a deficit. In the end it's all thermodynamics, no doubt, but we're trying to troubleshoot one of the most complex machines in existence, and we don't have a manual.

stevencloser

Yes, CI can be affected by obtuse factors like excretion and poor metabolism, but it will never become a larger amount of energy than it contains.

That's really poorly worded but my head hurts so screw it :P

And that's really the point - factors can and do affect both CI and CO, but at the end of the day if CI is less* than CO weightloss WILL occur.


*scientifically, not just assumed to be

None of the rest of this discussion invalidates that.

True, but if you can't really determine the numbers, then you have to do more to cover that margin of error. And regardless of that, isnt' everyone interested in figuring out the most effective way that works for them? If lowering or raising their carbs, depending on the individual, results in greater, more effective results, doesn't everyone want to know that?

Doesn't everyone want to maximize their efforts? Get the most bang for their buck? And, isn't finding the most effective way what will lead to the most sustainable longterm changes?

You would think so! I know for a fact that when my anxiety level goes up, I crave carbs. I also know in order for me to lose the weight I did, I had to reduce my carbs by 10% of the MFP default. So, it doesn't matter what anyone says about CICO or eat what ever carbs you want, I know I need to keep my carbs on the lower side. Others can eat a steady diet of carbs and still lose weight. I can't. These very same people may find after losing their desired weight that they may have to adjust their carbs to maintain or perhaps they will be able to keep the same ratio. At any rate you can't paint all with the same paint brush which is what CICO is doing to some degree.

Are you saying that if you had kept your carbs relatively higher but decreased your calories from protein and/or fat substantially, you wouldn't have lost weight?

If so, I'm once again back to doubting that you truly understand CICO.

Yes, or a lot less weight for the same caloric deficit. Anyone with insulin resistance is sadly very familiar with this. Some use medication, but many have to use low carb as well as medication.

That was the point of that whole study.

But the IR and IS people with the lowest weight loss were exactly at the expected amount of weight loss. I think I said this a few times already. The ones with the "wrong" diet had completely normal weight loss.

OkamiLavande

Is today a slow Monday for everyone? It seems like a slow Monday.

jofjltncb6

13 posts until decision time.

Are you in or out?

lindsey1979

Yes, CI can be affected by obtuse factors like excretion and poor metabolism, but it will never become a larger amount of energy than it contains.

That's really poorly worded but my head hurts so screw it :P

And that's really the point - factors can and do affect both CI and CO, but at the end of the day if CI is less* than CO weightloss WILL occur.


*scientifically, not just assumed to be

None of the rest of this discussion invalidates that.

True, but if you can't really determine the numbers, then you have to do more to cover that margin of error. And regardless of that, isnt' everyone interested in figuring out the most effective way that works for them? If lowering or raising their carbs, depending on the individual, results in greater, more effective results, doesn't everyone want to know that?

Doesn't everyone want to maximize their efforts? Get the most bang for their buck? And, isn't finding the most effective way what will lead to the most sustainable longterm changes?

You would think so! I know for a fact that when my anxiety level goes up, I crave carbs. I also know in order for me to lose the weight I did, I had to reduce my carbs by 10% of the MFP default. So, it doesn't matter what anyone says about CICO or eat what ever carbs you want, I know I need to keep my carbs on the lower side. Others can eat a steady diet of carbs and still lose weight. I can't. These very same people may find after losing their desired weight that they may have to adjust their carbs to maintain or perhaps they will be able to keep the same ratio. At any rate you can't paint all with the same paint brush which is what CICO is doing to some degree.

Are you saying that if you had kept your carbs relatively higher but decreased your calories from protein and/or fat substantially, you wouldn't have lost weight?

If so, I'm once again back to doubting that you truly understand CICO.

Yes, or a lot less weight for the same caloric deficit. Anyone with insulin resistance is sadly very familiar with this. Some use medication, but many have to use low carb as well as medication.

That was the point of that whole study.

But the IR and IS people with the lowest weight loss were exactly at the expected amount of weight loss. I think I said this a few times already. The ones with the "wrong" diet had completely normal weight loss.

Right, but you can imagine situations where the insulin resistance is more severe, so the results of the higher carb diets would be even more skewed, right?

And in the end, I don't think it really matters -- it shows that there are different results based on the same calories but different macros. That in and of itself shows that mere caloric value is not all that is involved.

Sarauk2sf

Okay, then how do isocaloric diets (with the same caloric deficits) result in different weight loss? If it's all CICO, then the macros shouldn't matter and the results should be the same.

Because the measured calorie expenditure, hence deficit, can only ever be an approximation. Lots of different factors are going to affect expenditure, which will lead to absorption of energy by the body to be less than forecast, far fewer lead to it being greater than forecast.

The key point in your statement is different weight loss, yet upthread we've got people claiming a significant deficit yet gaining weight. Not going to happen, unless they're storing solar energy and wind power.

Sure, but mathematically, you can imagine a scenario with the right numbers manipulation where someone could gain or stay the same whereas another lost -- you'd just have to shift the bar for the calculated deficit closer to maintenance.

But different weight loss is the whole point. If all calories were created equal and quantity was the ONLY thing that matter, then the results would be the same. Since they are different, there is another factor(s) at play that are not accounted for in sheer caloric value.

This is still just variables in the CO portion. It does not negate the fact that you need to be in a caloric deficit to lose fat.

Once again, not my point. I'm not saying that you don't need to be in a caloric deficit, but how you manipulate that deficit will make a difference in your weight loss. So, it's not all about sheer caloric value -- otherwise, results wouldn't differ, and they do.

Am I not saying this clearly?

I think I have pretty much understood what you are saying (and generally do not disagree) - however, in a thread where some people try to indicate that you can gain weight on a deficit, I think it important to make the point that it is not what you are saying.

Also, I wanted to make it clear that results differ mainly when you look at people with metabolic issues. When you look at populations when they do not have them (and even in conflicting studies where they do to be honest), then results do not differ significantly.

I agree that people who think CICO is totally invalid are way off, so I totally agree with you wanting to dispel that notion. But, on the flipside, there are a LOT more people that I've seen that say CICO is the ONLY thing. And I'd like to dispel that notion as well.

As I said before, I think they're both important parts of the weight loss puzzle for people.

Both important, but all calories are not equal how they effect blood sugar and uptake.

...but what does that have to do with CICO?

The point being it's not CICO, but many factors.

For example if you have Hypothyroidism, will cause you to gain weight with the same calories you were eating previously.
Another example is when you get pregnant.

But all that does is change the CO part. It's like saying 2 - 2 =/= 2 - 3 =/= 1 - 3 .

No, eating same calories with different result.

So, when you are pregnant, your CO =/= when you are not?

Edited to try to fix quotes

3dogsrunning

13 posts until decision time.

Are you in or out?

Out. I am so out. This thread is like banging your head repeatedly on the desk.
The super secret hidden messages makes it hurt that much more.

jmv7117

Yes, CI can be affected by obtuse factors like excretion and poor metabolism, but it will never become a larger amount of energy than it contains.

That's really poorly worded but my head hurts so screw it :P

And that's really the point - factors can and do affect both CI and CO, but at the end of the day if CI is less* than CO weightloss WILL occur.


*scientifically, not just assumed to be

None of the rest of this discussion invalidates that.

True, but if you can't really determine the numbers, then you have to do more to cover that margin of error. And regardless of that, isnt' everyone interested in figuring out the most effective way that works for them? If lowering or raising their carbs, depending on the individual, results in greater, more effective results, doesn't everyone want to know that?

Doesn't everyone want to maximize their efforts? Get the most bang for their buck? And, isn't finding the most effective way what will lead to the most sustainable longterm changes?

You would think so! I know for a fact that when my anxiety level goes up, I crave carbs. I also know in order for me to lose the weight I did, I had to reduce my carbs by 10% of the MFP default. So, it doesn't matter what anyone says about CICO or eat what ever carbs you want, I know I need to keep my carbs on the lower side. Others can eat a steady diet of carbs and still lose weight. I can't. These very same people may find after losing their desired weight that they may have to adjust their carbs to maintain or perhaps they will be able to keep the same ratio. At any rate you can't paint all with the same paint brush which is what CICO is doing to some degree.

Are you saying that if you had kept your carbs relatively higher but decreased your calories from protein and/or fat substantially, you wouldn't have lost weight?

If so, I'm once again back to doubting that you truly understand CICO.

That is exactly what I am saying based on my experience. I was at a deficit yet barely losing and definitely well under the rate I should have been at. I reduced the carbs, stayed at the same deficit and the weight starting melting off. Yes, I do understand CICO which is why I don't fully attribute weight loss to it alone. Hormones can and do affect calorie burn in your body. For whatever reason, my body does not lose well at a higher carb ratio. I know this and can adjust accordingly. This is why I think it is important for others to pay attention to the trends they see during their weight loss journey rather than follow blindly the CICO ideal.

59gi

If you're thyroid stops functioning and you start eating less, you will not gain weight.

I have to politely disagree with this statement.

In preparation for my radiation treatment for thyroid cancer (my thyroid was removed) I had to stop taking my thyroid meds and I had to follow, and was 100% compliant, a very restrictive diet. I was was eating less than 1200 calories per day.
I gained 15 pounds.

Right, because it is not cico, but many factors! Calories are one factor but, it's not CICO.

OkamiLavande

13 posts until decision time.

Are you in or out?

Out. I am so out. This thread is like banging your head repeatedly on the desk.
The super secret hidden messages makes it hurt that much more.

Lucky me isn't tapped out yet because I'm at home with nothing to do!

Sarauk2sf

Was the question 'what are quality foods' ever answered?

If so, was there any light shone on the exact impact on CICO (or the invalidity thereof?)

EvgeniZyntx

Calories in - calories out is 100% correct. For weightloss. However if you want to be healthy, you also want to make sure your macros are good too.

I think this says it all... end of argument.

Not all energy is created equally.

Conservation of energy: energy cannot be created nor can it be destroyed. It can only change from one state into another.

Also requires a closed system. The human body is not a closed system.

false. Conservation of energy applies to all systems. You cannot create or destroy energy in an open, isolated or closed system. You are thinking of the second law.

You're right. But CICO is based on BOTH laws, correct?

Nope. Neither.
We've covered tins upstream
Stay way from the physics. It. Does. Not. Apply. In. A. STRICT. Sense. Sorry, to be so rude but this has become a pet peeve from MFP. I'll give a concrete example.

Calories in food - those pesky 4 4 and 9 cals per gram are nice little estimation based on assumed standard metabolic pathways.
Change the metabolic pathway and poof no conservation. The only equation being followed is really the experimental Atwater equation.



Now, to debunk conservation of energy in biological systems - don't try this at home, kids.
Imagine an individual like you and me that eats x cals to maintain of a regular day with regular exercise. At x plus 500, our individual gains weight. So far so good.

We now take this same individual and inject regular doses of methylhexanamine (brought from India, illegal and quite dangerous) which up-regulates beta adrenergic receptors and the individual suddenly loses weight at x plus 500 (our patient eventually dies from seizures or a heart attack but not before their bladder lets go and they regularly piss themselves, but that's another story...)

What happened to conservation of energy. The same input gives a different output. Because we've changed the primary metabolic lipid paths. No increase in thermal output, no increase in energy use, just gone to a more efficient machine by setting the amount of free lipid triglycerides available on the blood stream quite a bit higher. (And if our patient didn't die from the methylhexanamine directly, maybe the new blood soup isn't going to be a lot of fun).

Conservation of energy works on the isolated components of the system but once you change paths the energy costs are different and you can toss the Atwater values out. A bunch of less severe drugs have metabolic impact (beta blockers, insulin, steroids...).

Conservation of energy is a strict concept. CICO is not; it allows for a lot of flexibility on the concept and outlines that calories in are an important (if not the most important) factor to weight loss. We've seen in the discussion above thread that substrate partitioning may have some influence on the exactness of CICO, this couldn't be true if conservation of energy was truly being observed.

59gi

Yes, CI can be affected by obtuse factors like excretion and poor metabolism, but it will never become a larger amount of energy than it contains.

That's really poorly worded but my head hurts so screw it :P

And that's really the point - factors can and do affect both CI and CO, but at the end of the day if CI is less* than CO weightloss WILL occur.


*scientifically, not just assumed to be

None of the rest of this discussion invalidates that.

True, but if you can't really determine the numbers, then you have to do more to cover that margin of error. And regardless of that, isnt' everyone interested in figuring out the most effective way that works for them? If lowering or raising their carbs, depending on the individual, results in greater, more effective results, doesn't everyone want to know that?

Doesn't everyone want to maximize their efforts? Get the most bang for their buck? And, isn't finding the most effective way what will lead to the most sustainable longterm changes?

You would think so! I know for a fact that when my anxiety level goes up, I crave carbs. I also know in order for me to lose the weight I did, I had to reduce my carbs by 10% of the MFP default. So, it doesn't matter what anyone says about CICO or eat what ever carbs you want, I know I need to keep my carbs on the lower side. Others can eat a steady diet of carbs and still lose weight. I can't. These very same people may find after losing their desired weight that they may have to adjust their carbs to maintain or perhaps they will be able to keep the same ratio. At any rate you can't paint all with the same paint brush which is what CICO is doing to some degree.

Are you saying that if you had kept your carbs relatively higher but decreased your calories from protein and/or fat substantially, you wouldn't have lost weight?

If so, I'm once again back to doubting that you truly understand CICO.

That is exactly what I am saying based on my experience. I was at a deficit yet barely losing and definitely well under the rate I should have been at. I reduced the carbs, stayed at the same deficit and the weight starting melting off. Yes, I do understand CICO which is why I don't fully attribute weight loss to it alone. Hormones can and do affect calorie burn in your body. For whatever reason, my body does not lose well at a higher carb ratio. I know this and can adjust accordingly. This is why I think it is important for others to pay attention to the trends they see during their weight loss journey rather than follow blindly the CICO ideal.

Excellent answer.

ChelseyDAdams

To #1 - NOPE! I think this is a good "general" rule that works for the majority. I have issues with hypothyroidism, which can mess with that formula. I will work out regularly, eat very healthy, and the scale will often stay the same or sometimes, frustratingly, go up! If I cut out certain foods that can aggravate thyroid, then the scale starts to ever so slowly move down.

Before they really understood thyroid (they still are figuring it out, but at least moving in the right direction) my mom gained over 100lbs in one year while exercising 10 hours a week and dieting! She was floored. The doctors just said she must have been lying about her activity and her eating because they had no concept beyond the "calories in, calories out" mentality.

So no, every body is different and, unfortunately, such a simple formula doesn't work as well for all of us. I sure wish...

EvgeniZyntx

If you're thyroid stops functioning and you start eating less, you will not gain weight.

I have to politely disagree with this statement.

In preparation for my radiation treatment for thyroid cancer (my thyroid was removed) I had to stop taking my thyroid meds and I had to follow, and was 100% compliant, a very restrictive diet. I was was eating less than 1200 calories per day.
I gained 15 pounds.

Right, because it is not cico, but many factors! Calories are one factor but, it's not CICO.

Calories remain most likely the single most important factor. Which is something you don't seem to understand.

LiftAllThePizzas

A couple questions. I used the search function but some of the info may be outdated - not sure.

#1) Do YOU believe in strictly calories in - calories out? As in, you could eat all of your calories in pure table sugar, and although its incredibly unhealthy, you would lose weight if you're in a caloric defecit? If so, is there ever a situation where a caloric deficit would NOT lead to weight loss?

#2) Ever since I introduced weight lifting (bench press, squat, dead lift, shoulders) 3 weeks ago, my weight loss has screeched to a snails pace (1 pound or less per week while being in a 2.5 pound caloric deficit). It is common knowledge that you don't build muscle while in a caloric defect. Am I holding onto water in the muscles for nearly 3 weeks now? As soon as I get my hands on a tape measure large enough I'll start measuring.

#3) If Insulin stores fat, how do we lose weight while eating carbs and sugars (even in a caloric deficit) while insulin levels are elevated?

Thanks.

1) NO!
2) Yes
3) it's complicated

Again, please enlighten us as to where the excess energy originates when someone ingests fewer calories than they've burned off during any particular time period. If you know how to conjure free energy without a source, you hold the key to the future of humanity's energy needs and could single-handedly change the course of history and be the greatest hero humankind has ever known! Why would someone hold back such a valuable secret?

Also, do you pay an electric bill? Or do you use this advanced technology to power your own household?

stevencloser

Calories in - calories out is 100% correct. For weightloss. However if you want to be healthy, you also want to make sure your macros are good too.

I think this says it all... end of argument.

Not all energy is created equally.

Conservation of energy: energy cannot be created nor can it be destroyed. It can only change from one state into another.

Also requires a closed system. The human body is not a closed system.

false. Conservation of energy applies to all systems. You cannot create or destroy energy in an open, isolated or closed system. You are thinking of the second law.

You're right. But CICO is based on BOTH laws, correct?

Nope. Neither.
We've covered tins upstream
Stay way from the physics. It. Does. Not. Apply. In. A. STRICT. Sense. Sorry, to be so rude but this has become a pet peeve from MFP. I'll give a concrete example.

Calories in food - those pesky 4 4 and 9 cals per gram are nice little estimation based on assumed standard metabolic pathways.
Change the metabolic pathway and poof no conservation. The only equation being followed is really the experimental Atwater equation.



Now, to debunk conservation of energy in biological systems - don't try this at home, kids.
Imagine an individual like you and me that eats x cals to maintain of a regular day with regular exercise. At x plus 500, our individual gains weight. So far so good.

We now take this same individual and inject regular doses of methylhexanamine (brought from India, illegal and quite dangerous) which up-regulates beta adrenergic receptors and the individual suddenly loses weight at x plus 500 (our patient eventually dies from seizures or a heart attack but not before their bladder lets go and they regularly piss themselves, but that's another story...)

What happened to conservation of energy. The same input gives a different output. Because we've changed the primary metabolic lipid paths. No increase in thermal output, no increase in energy use, just gone to a more efficient machine by setting the amount of free lipid triglycerides available on the blood stream quite a bit higher. (And if our patient didn't die from the methylhexanamine directly, maybe the new blood soup isn't going to be a lot of fun).

Conservation of energy works on the isolated components of the system but once you change paths the energy costs are different and you can toss the Atwater values out. A bunch of less severe drugs have metabolic impact (beta blockers, insulin, steroids...).

Conservation of energy is a strict concept. CICO is not; it allows for a lot of flexibility on the concept and outlines that calories in are an important (if not the most important) factor to weight loss. We've seen in the discussion above thread that substrate partitioning may have some influence on the exactness of CICO, this couldn't be true if conservation of energy was truly being observed.

But injecting that stuff doesn't make any energy suddenly poof into nonexistence which conservation of energy is about. It still exists but goes somewhere else (probably gets excreted in your example?)