Calories in calories out is it that simple?

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  • lemurcat12
    lemurcat12 Posts: 30,886 Member
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    blambo61 wrote: »
    Physics (thermo) demands that you lose at least as much as a calorie deficit (you can lose more) and that you can gain no more than a surplus (you don't have to gain all that). CICO is a great model in that it bounds weight loss/gain as just described. It doesn't mean that other things don't help (you can gain less and you can lose more). Whether you lose more than a deficit demands or don't put on as much as a surplus depends on what and when you eat also. CI the mouth are not equivalent to calories in a fat cell. There are energy losses in digestion, there is excretion where calories are not used.

    Talking about trying to find ways to not use the calories we input always sounds dangerous to me, and definitely the wrong mindset -- a mild form of purging or abusing laxatives, really, or like that invention where you can dump stomach content.

    Seems healthier to me to focus on learning to eat only what you need.

    The body isn't going to make wasting calories easy, either, since evolutionarily that would not have been helpful. Calories going through you without being used is normally a sign of illness.
    There are losses depending on the path we get our energy from. The more gluconeogenisis you do (inefficient process) the more you will lose eating the same calories. Fasting and low carb force more gluconeogenisis.

    Eh, I'm skeptical about that and, in any case, any TEF or whatever it's called increase from that with low carb would be offset -- certainly at a calorie excess -- by the fact that the body can more easily turn fat into fat than carbs. Not that it's hard to do with carbs, but there's a thermic cost to that too.

    I low carb, but not because I think it wastes calories, and it doesn't seem to, from my results.
    One thing I see that can get people into trouble, besides eating junk which will make you very hungry, is constantly never eating tell full and driving the BMR down very low so that it is hard to have a deficit.

    I mostly eat a very healthy diet (IMO), but "junk" (which is vague) doesn't invariably make me hungry at all. Had a rare restaurant burger and fries the other day, and I was STUFFED for ages after, it could have been my only meal but for vegetables, easily. If I fit in 200 calories of ice cream after dinner (which I am not doing now, but at times have done very regularly), it doesn't make me hungry. And I don't believe these things "drive down the BMR," as there is no scientific reason why they would.

    Is it unhealthy to live on only burgers, fries, and ice cream (which NO ONE recommends)? Obviously. But that's a different question.
  • Agent_Freckles
    Agent_Freckles Posts: 79 Member
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    earlnabby wrote: »
    kimny72 wrote: »
    JustRobby1 wrote: »
    According to the AMA and other authoritative bodies within the United States, a "balanced diet" is not really all that subjective, and looks something like this:

    mg69rd99y1ck.jpg

    However, I think you will find many people among the fad diet crowd who would not find this to be healthy at all. Such a diet would fill them with paranoia. Bread, cheese, rice, pasta, butter (on my!) or nearly any other individual food on the above graphic representing a balanced diet has to the potential to cause several dieting cults or "clean" eating psychos to lose their cookies. Why? Because most of these individual sects operate largely outside the realm of medical science and nutrition and rely instead on semantics and pop culture to forward their ideas.

    Regardless of this, I know one universal way to improve health and decrease risk for a wide assortment of health related conditions and diseases, and that is to decrease your BMI. In this context your diet of choice is largely irrelevant. Be it clean, balanced or otherwise. the biological mechanism to achieve weight loss is identical.

    If you are diabetic, that's a terrible diet. I wonder if the AMA makes a differentiation. PS - your average doctor knows nothing about diet and nutrition.

    Why should the average person worry about being diabetic?

    Diabetes also doesn't mean you have to forgo carbs.

    Paging @earlnabby .

    Because the way things are going, in 20 years the average person will be diabetic.

    Yes, diabetes means you should forgo grains, sugars and starches as much as possible, unless you want to slowly deteriorate over the course of your life because of the diabetes. It's a fact.

    Do you know what causes diabetes? I don't think you do.

    Yes I do. And I did not say grains, starches and sugar cause T2 diabetes. You should avoid grains, sugars and starches if you are pre-T2 or T2. Unless you want to inject large amounts of insulin for the rest of your life, likely gain weight, and likely be a lot less healthy than people who do not have T2.

    Incorrect. You should manage them. You don't need to avoid them. Some T2's need to avoid certain grains and not others.

    What T2's should do is reach a normal weight and become active.

    Again, paging @earlnabby

    I have read case after case on-line of people stopping or reversing T2 diabetes not by avoiding carbs (green veggies have carbs and you can eat all the green veggies you want), but avoiding, as best as you can, grains, starches and sugars. Why? Because they have a high glycemic index.

    That's it. Not making this up. If you don't want to believe me, that's fine.

    Perhaps by avoiding grains, starches, and sugars they reduced their calories and lost weight? I find it odd that you are telling people with diabetes that what they and their doctors did to reverse their diabetes is wrong because... you read stuff online. You are saying that the American Diabetes Association and many diabetics here who have reversed all sorts of bad numbers, including diabetes, are wrong and your expertise is Google?

    Yes, I can see by the great reduction in the number of Type 2 diabetics that the American Diabetes Association has really done a great job over the years with their dietary recommendations.

    Unfortunately, we are dealing with human beings here. They have been told for decades to lose weight and get active in order to lower their risk for diabetes. How many actually have? Not nearly enough. Can't blame the scientists and doctors when people refuse to heed the advice and warnings. The dietary recommendations are sound. People just don't want to adhere to them.

    Same thing with those who develop the disease. Some take charge and do what they need to do in order to manage it (lose weight, get active, figure out how many carbs they need to be eating, etc), many others don't.

    You can lead the horse to water . . .

    I work at a hospital; it's sad to see the amount of people struggling with type 2 diabetes. Many have to have toes and feet amputated. Some are even skinny-- like actually skinny. You'd be surprised.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
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    I'm sure some people with T2D are "skinny." However, the stats I've seen are that around 85% to over 90% of those with T2D are overweight or obese. I expect that's even higher among younger people with T2D (it's much more common still among those over 65).

    Interestingly, the minority of those with T2D who are NOT overweight are more likely to die of it or related diseases sooner, according to what I found when googling around for stats. This could be because they are actually obese but simply not according to BMI (in other words very high fat percentage for their weight) and that that can be more dangerous than being more muscular and also fat, as it often correlates with metabolic syndrome (I did not know this before, interesting). There also is an obesity paradox that may be in play although researchers were surprised to see it with a condition that is so related to obesity as it's trigger.
  • kimny72
    kimny72 Posts: 16,013 Member
    edited September 2017
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    kimny72 wrote: »
    JustRobby1 wrote: »
    According to the AMA and other authoritative bodies within the United States, a "balanced diet" is not really all that subjective, and looks something like this:

    mg69rd99y1ck.jpg

    However, I think you will find many people among the fad diet crowd who would not find this to be healthy at all. Such a diet would fill them with paranoia. Bread, cheese, rice, pasta, butter (on my!) or nearly any other individual food on the above graphic representing a balanced diet has to the potential to cause several dieting cults or "clean" eating psychos to lose their cookies. Why? Because most of these individual sects operate largely outside the realm of medical science and nutrition and rely instead on semantics and pop culture to forward their ideas.

    Regardless of this, I know one universal way to improve health and decrease risk for a wide assortment of health related conditions and diseases, and that is to decrease your BMI. In this context your diet of choice is largely irrelevant. Be it clean, balanced or otherwise. the biological mechanism to achieve weight loss is identical.

    If you are diabetic, that's a terrible diet. I wonder if the AMA makes a differentiation. PS - your average doctor knows nothing about diet and nutrition.

    Why should the average person worry about being diabetic?

    Diabetes also doesn't mean you have to forgo carbs.

    Paging @earlnabby .

    Because the way things are going, in 20 years the average person will be diabetic.

    Yes, diabetes means you should forgo grains, sugars and starches as much as possible, unless you want to slowly deteriorate over the course of your life because of the diabetes. It's a fact.

    Do you know what causes diabetes? I don't think you do.

    Yes I do. And I did not say grains, starches and sugar cause T2 diabetes. You should avoid grains, sugars and starches if you are pre-T2 or T2. Unless you want to inject large amounts of insulin for the rest of your life, likely gain weight, and likely be a lot less healthy than people who do not have T2.

    Incorrect. You should manage them. You don't need to avoid them. Some T2's need to avoid certain grains and not others.

    What T2's should do is reach a normal weight and become active.

    Again, paging @earlnabby

    I have read case after case on-line of people stopping or reversing T2 diabetes not by avoiding carbs (green veggies have carbs and you can eat all the green veggies you want), but avoiding, as best as you can, grains, starches and sugars. Why? Because they have a high glycemic index.

    That's it. Not making this up. If you don't want to believe me, that's fine.

    Perhaps by avoiding grains, starches, and sugars they reduced their calories and lost weight? I find it odd that you are telling people with diabetes that what they and their doctors did to reverse their diabetes is wrong because... you read stuff online. You are saying that the American Diabetes Association and many diabetics here who have reversed all sorts of bad numbers, including diabetes, are wrong and your expertise is Google?

    Yes, I can see by the great reduction in the number of Type 2 diabetics that the American Diabetes Association has really done a great job over the years with their dietary recommendations.

    But that's about people becoming diabetic, not controlling their diabetes once they have it.

    Considering that a large % of Americans are obese, I'm not surprised there has been no reduction in the rate of diabetes. And we were talking about reversing diabetes, not avoiding it in the first place.

    Still not sure what that has to do with glycemic index or grains and starches. Are you saying that regardless of weight, activity, and blood pressure, the glycemic index of food is what causes diabetes? Are you assuming most people eat grains and starches alone, since eating a high-glycemic food with a fat or protein or fiber reduces the glycimic load of the meal? Could you point us to where we can see these case studies where people reduced the sugars grains and starches without changing anything else (calories, weight, activity) and reversed diabetes?
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    edited September 2017
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    That does not say they got the results without changing anything else, like calories, as kimny requested.

    I've never seen anything showing they could. I have seen various trials of weight loss with low carb AND weight loss with low fat showing in both cases good (and fast) result for people with T2D. In both cases the diet quality improved for other reasons too and calories were lowered.

    I've seen an experiment with kids on terrible, super high sugar (and otherwise bad) diets where they switched sugar to starch and saw good results, but even there it seems the calories also decreased some.
  • Agent_Freckles
    Agent_Freckles Posts: 79 Member
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    lemurcat12 wrote: »
    I'm sure some people with T2D are "skinny." However, the stats I've seen are that around 85% to over 90% of those with T2D are overweight or obese. I expect that's even higher among younger people with T2D (it's much more common still among those over 65).

    Interestingly, the minority of those with T2D who are NOT overweight are more likely to die of it or related diseases sooner, according to what I found when googling around for stats. This could be because they are actually obese but simply not according to BMI (in other words very high fat percentage for their weight) and that that can be more dangerous than being more muscular and also fat, as it often correlates with metabolic syndrome (I did not know this before, interesting). There also is an obesity paradox that may be in play although researchers were surprised to see it with a condition that is so related to obesity as it's trigger.

    Yeah, the majority of them are overweight, but even 15% of them being at a normal BMI is (was) surprising to me. Or maybe that's just me.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    edited September 2017
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    lemurcat12 wrote: »
    That does not say they got the results without changing anything else, like calories, as kimny requested.

    I've never seen anything showing they could. I have seen various trials of weight loss with low carb AND weight loss with low fat showing in both cases good (and fast) result for people with T2D. In both cases the diet quality improved for other reasons too and calories were lowered.

    I've seen an experiment with kids on terrible, super high sugar (and otherwise bad) diets where they switched sugar to starch and saw good results, but even there it seems the calories also decreased some.

    She doesn't tell her clients to count calories.

    And her focus is not weight loss, it is stopping or reversing Type 2 diabetes.

    Dietary change leads to weight loss in many cases, through ad libitum reduced calories.

    It's NOT common sense that if you have T2D you fix it by cutting out carbs. You might need to if you can't control it otherwise, but far better to make it so your body can deal with carbs, is not IR. THAT seems to happen for many when they lose weight and generally eat a good diet (which means balanced carbs, higher fiber carbs in many cases, and often fruit and veg are HELPFUL, despite being carbs).

    Controlling symptoms if one cannot otherwise fix the problem might ultimately be necessary, but it doesn't seem to be in many cases, and weight loss is generally the best response.

    For some who are IR -- and WHY O WHY is every thread hijacked to be about boring IR? I am not IR and was not even when fat -- cutting carbs may make it easier to maintain a deficit, but for others, even others who are IR, it can make it harder, so better to look at other things.

    Plenty of cultures with higher carbs than the US have extremely low or even virtually non existent rates of T2D.

    Here's something on Hallberg and the low carb advice as the one and only go-to for diabetics and the lack of evidence: https://www.nytimes.com/2016/09/16/health/type-2-diabetes-low-carb-diet.html

    If you use anecdotes, you have to add in the Fuhrmans and Campbells and so on and their successes with different ways of eating and people who improve their diabetes.
  • WinoGelato
    WinoGelato Posts: 13,454 Member
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    lemurcat12 wrote: »
    That does not say they got the results without changing anything else, like calories, as kimny requested.

    I've never seen anything showing they could. I have seen various trials of weight loss with low carb AND weight loss with low fat showing in both cases good (and fast) result for people with T2D. In both cases the diet quality improved for other reasons too and calories were lowered.

    I've seen an experiment with kids on terrible, super high sugar (and otherwise bad) diets where they switched sugar to starch and saw good results, but even there it seems the calories also decreased some.

    She doesn't tell her clients to count calories.

    And her focus is not weight loss, it is stopping or reversing Type 2 diabetes.

    You don't have to count calories in order to be in a calorie deficit.

    The point people are making is that whether it's your focus or not, the weight loss itself significantly contributed to managing or reversing type 2 diabetes.

    What people are not saying is that you don't need to pay attention to carbs and sugars. Just that it isn't always a strict requirement to cut out those types of foods, that it is possible to be quite successful in managing this disease by losing weight and watching levels while being mindful of the intake of those types of foods.

    There are a vast number of people who find extreme dietary changes to be so daunting they either think "why bother" or they try and ultimately cannot sustain the extreme approach. Letting people know that losing weight without extreme changes can still have a very positive outcome on managing or reversing Type 2 diabetes should be the goal - not setting people up for failure by telling them they can never eat the the foods they love again.
  • blambo61
    blambo61 Posts: 4,372 Member
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    lemurcat12 wrote: »
    blambo61 wrote: »
    Physics (thermo) demands that you lose at least as much as a calorie deficit (you can lose more) and that you can gain no more than a surplus (you don't have to gain all that). CICO is a great model in that it bounds weight loss/gain as just described. It doesn't mean that other things don't help (you can gain less and you can lose more). Whether you lose more than a deficit demands or don't put on as much as a surplus depends on what and when you eat also. CI the mouth are not equivalent to calories in a fat cell. There are energy losses in digestion, there is excretion where calories are not used.

    Talking about trying to find ways to not use the calories we input always sounds dangerous to me, and definitely the wrong mindset -- a mild form of purging or abusing laxatives, really, or like that invention where you can dump stomach content.

    I never said anything about laxatives or purging. I said that fasting and low carb could be helpful since more gluconeogenisis would be required which will burn more calories than eating a carb based diet in many meals with the same calories as the fasting and/or low carb diet.

    Seems healthier to me to focus on learning to eat only what you need.

    The body isn't going to make wasting calories easy, either, since evolutionarily that would not have been helpful. Calories going through you without being used is normally a sign of illness.

    Poop burns, there are calories in it. Also we breath out the by-products of fat metabolism (water and CO2).
    There are losses depending on the path we get our energy from. The more gluconeogenisis you do (inefficient process) the more you will lose eating the same calories. Fasting and low carb force more gluconeogenisis.

    Eh, I'm skeptical about that and, in any case, any TEF or whatever it's called increase from that with low carb would be offset -- certainly at a calorie excess -- by the fact that the body can more easily turn fat into fat than carbs. Not that it's hard to do with carbs, but there's a thermic cost to that too.

    If person is fasting, they are getting more energy from gluconeogenisis than if they had the same calories spread out. Gluconeogenisis is an inefficient process so more calories are used up to provide the energy needed. Any process has losses. Gluconeogenisis has more steps and more losses.

    I low carb, but not because I think it wastes calories, and it doesn't seem to, from my results.
    One thing I see that can get people into trouble, besides eating junk which will make you very hungry, is constantly never eating tell full and driving the BMR down very low so that it is hard to have a deficit.

    I mostly eat a very healthy diet (IMO), but "junk" (which is vague) doesn't invariably make me hungry at all. Had a rare restaurant burger and fries the other day, and I was STUFFED for ages after, it could have been my only meal but for vegetables, easily. If I fit in 200 calories of ice cream after dinner (which I am not doing now, but at times have done very regularly), it doesn't make me hungry. And I don't believe these things "drive down the BMR," as there is no scientific reason why they would.

    Eating sugary foods will make a person more hungry. I think that is common knowledge. It spikes you blood sugar, which spikes insulin, which lowers blood sugar which makes you hungry. If you eat your sugars with other things the effect is diminished.

    Is it unhealthy to live on only burgers, fries, and ice cream (which NO ONE recommends)? Obviously. But that's a different question.

  • GottaBurnEmAll
    GottaBurnEmAll Posts: 7,722 Member
    edited September 2017
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    Once more, why is this thread about diabetes and IR?

    I asked that question once and went down the rabbit trail and I'm sorry I did.

    The Blue Zone populations which thrive on high carb diets have low rates of T2D. Traditional diets abound that are both high and low carb and have populations with low rates of T2D. What all these populations have in common is rates of calorie consumption that are in line with the rates of energy expenditure that keep the population at normal healthy body weights.

    When you have societies eating diets that make them obese, and normally, in these diets, fat is more problematic than carbs and so is being sedentary, that's when you get problems.

    Since there are populations thriving on both high and low carb diets, it's really clear that this silly crusade of insisting you have to eat just one way to address T2D is wrong-headed. That's not what is causing T2D, and that's not the only solution for reversing it.

    Furthermore, to come on a thread about energy balance and make it about T2D is just comical. Not everyone has the genetic factors involved that predispose them to it.

    If the crusade to eat a certain way is spreading a cautionary tale, it's quite clear that the PP doesn't understand the causes of the disease. Hint: it's not eating a certain way, unless, of course, you only mean eating too much and remaining overweight.
  • lemurcat12
    lemurcat12 Posts: 30,886 Member
    edited September 2017
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    Gah, it's not that tough to quote properly.

    In all that, blambo, I pick out: "Eating sugary foods will make a person more hungry. I think that is common knowledge."

    No, as I said, eating some ice cream or chocolate (say, 200 cal) within the context of a healthful, very satiating day, never makes me hungry. I never had an issue with hunger at all, really. I cut my calories to below 1200 when I first started and was not hungry (although once I realized I was doing it I fixed it, because it was dumb). This was in part because I naturally focused on lean protein and veg and am a volume eater to some extent (and I love and find vegetables satisfying and sating). Anyway, it's more important to me to have an overall healthful, enjoyable, varied, and satisfying diet than anything else, as that is what will keep me consistent. Obsessing about maximizing the calories on paper I can put in my mouth seems, well, not sensible at all (trying to increase the calorie content of your BM, LOL, and like I said before seems too much like abusing laxatives in the mindset, but hey, if you are that desperate to put more calories in your mouth, go for it). Saying if someone ever has sugar they can't be satisfied or sated also is obviously false. Can sugary treats often be consumed even if one is not really that hungry and thus overeaten? Sure, duh. But that doesn't mean that one can't be sated if one occasionally consumes them.

    What leads to satiety and whether hunger is even a problem is really more individual.

    I would agree that if one is struggling to stay within one's calories one should think about food choice and meal timing as well as some other factors, like habits (and NOT whether I can make my body waste calories, which seems a screwed up focus, as I said before).

    However, I would not agree that you can make absolute declarations about what will and will not work for someone when it comes to food choice.
  • earlnabby
    earlnabby Posts: 8,171 Member
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    lemurcat12 wrote: »
    That does not say they got the results without changing anything else, like calories, as kimny requested.

    I've never seen anything showing they could. I have seen various trials of weight loss with low carb AND weight loss with low fat showing in both cases good (and fast) result for people with T2D. In both cases the diet quality improved for other reasons too and calories were lowered.

    I've seen an experiment with kids on terrible, super high sugar (and otherwise bad) diets where they switched sugar to starch and saw good results, but even there it seems the calories also decreased some.

    She doesn't tell her clients to count calories.

    And her focus is not weight loss, it is stopping or reversing Type 2 diabetes.

    The two are not mutually exclusive. Losing weight (assuming one is overweight) and becoming more active are the first things newly diagnosed diabetics are told to do. It is the first line of treatment. Losing weight improves the body's ability to handle glucose and activity (cardio type especially) helps "burn off" the excess glucose in the bloodstream. Need to drop your blood glucose by 15-20 points? Go take a 20 minute brisk walk.
  • VintageFeline
    VintageFeline Posts: 6,771 Member
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    Thank you lemur for picking through that. I admit I skipped the effort!

    And it depends on the sugary food for me. I had a sugary, carby food the other morning with a coffee. Full for hours. I don't do it often really but bready things, yes, even covered in sugar, are very satiating to me. Particularly in the morning for whatever reason.
  • blambo61
    blambo61 Posts: 4,372 Member
    edited September 2017
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    lemurcat12 wrote: »
    Gah, it's not that tough to quote properly.

    In all that, blambo, I pick out: "Eating sugary foods will make a person more hungry. I think that is common knowledge."

    No, as I said, eating some ice cream or chocolate (say, 200 cal) within the context of a healthful, very satiating day, never makes me hungry. I never had an issue with hunger at all, really. I cut my calories to below 1200 when I first started and was not hungry (although once I realized I was doing it I fixed it, because it was dumb). This was in part because I naturally focused on lean protein and veg and am a volume eater to some extent (and I love and find vegetables satisfying and sating). Anyway, it's more important to me to have an overall healthful, enjoyable, varied, and satisfying diet than anything else, as that is what will keep me consistent. Obsessing about maximizing the calories on paper I can put in my mouth seems, well, not sensible at all (trying to increase the calorie content of your BM, LOL, and like I said before seems too much like abusing laxatives in the mindset, but hey, if you are that desperate to put more calories in your mouth, go for it). Saying if someone ever has sugar they can't be satisfied or sated also is obviously false. Can sugary treats often be consumed even if one is not really that hungry and thus overeaten? Sure, duh. But that doesn't mean that one can't be sated if one occasionally consumes them.

    You totally mis-characterizing what I stated. I enjoy a varied diet and I don't like going low carb. I'm just making a statement that I think it does help (it won't help me in the long run if I can't stick to a low carb diet and I would be afraid of missing out on some nutrients doing that). Eating sugar early in the day will make me crazy hungry and I think that is very common, I don't have the same reaction if I eat it at the end of the day after a good meal so I should have qualified that statement more. I'm obsessing/desperate about trying to maximize the calories I can eat and trying to increase caloric content of BM? Where did you get that from? No, I want a deficit, as calculated by CICO, and I will also enjoy any extra help I can get if I'm a little carb conscious or do some fasting. I do fasting because it helps me to control my calorie intake. I also think there is some additional benefits as explained. I have lost my weight eating sugary stuff probably every night after dinner. I do bet most people will be very hungry shortly after eating a sugary breakfast.

    What leads to satiety and whether hunger is even a problem is really more individual.

    I would agree that if one is struggling to stay within one's calories one should think about food choice and meal timing as well as some other factors, like habits (and NOT whether I can make my body waste calories, which seems a screwed up focus, as I said before).

    Again, I'm not trying to get my body to waste calories, I fast to not overeat and there is some additional benefit that just happens. Not sure how you draw your conclusions as to my intentions or why you totally misconstrue what I've said. I praised CICO as a good model and your making it sound like I'm telling people to take laxatives!

    However, I would not agree that you can make absolute declarations about what will and will not work for someone when it comes to food choice.
  • psuLemon
    psuLemon Posts: 38,401 MFP Moderator
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    lemurcat12 wrote: »
    I'm sure some people with T2D are "skinny." However, the stats I've seen are that around 85% to over 90% of those with T2D are overweight or obese. I expect that's even higher among younger people with T2D (it's much more common still among those over 65).

    Interestingly, the minority of those with T2D who are NOT overweight are more likely to die of it or related diseases sooner, according to what I found when googling around for stats. This could be because they are actually obese but simply not according to BMI (in other words very high fat percentage for their weight) and that that can be more dangerous than being more muscular and also fat, as it often correlates with metabolic syndrome (I did not know this before, interesting). There also is an obesity paradox that may be in play although researchers were surprised to see it with a condition that is so related to obesity as it's trigger.

    Yeah, the majority of them are overweight, but even 15% of them being at a normal BMI is (was) surprising to me. Or maybe that's just me.

    I'd probably say it's just you (well and anyone who hasn't researched causes or had discussion on causes). If you look at common causes of diabetes, it's obesity, activity level and genetics/family history. Additionally, people of certain races have much higher probabilities of becoming T2 diabetic, regardless of diet. There are just so many diseases that have a genetic component, it's not even funny.