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Anyone else frustrated with the CICO mantra?

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  • MargaretYakoda
    MargaretYakoda Posts: 1,944 Member
    edited August 1
    EyeOTS wrote: »
    Yes, I also get frustrated with it. I get additionally frustrated with other people getting intensely pushy about it the moment you even remotely say there is something wrong with the dogmatic approach it has. I live with a scientist and she has many of the similar complaints that you have. She was also remarkably doubtful of my own methods when a few years ago I determined that CICO wasn't enough for me. I actually did more research on it than she did and I had to do a whole lot of my own homework and tests on my own body until I found something that actually did work for me. She later came to accept that I was right about my approach.

    So as far as frustration goes, there is a personal frustration for both myself in that it didn't work for me. Additionally, when it didn't work, most people insisted that I was either doing it wrong or were adamant that I was lying about what I was writing down in my logs. The CICO community can be very supportive, but in this regard, remarkably toxic when it comes to people who have trouble with it. The latter frustration is on behalf of others. The frustration on behalf of others is compounded by other abusive perspectives on weight, such as hearing endless stories about women doing all that they could to get a diagnosis for their health problems and only being told that they should lose weight.

    Scientifically speaking, weight loss approaches are pretty witchdoctor-y at this stage as it's actually not entirely well understood why we gain or lose weight, especially when it comes to differences between men, women, transgender folk and other genders who take HRT and have changes in their metabolism and chemical make-up. The latter two especially have next to no understanding, if any.

    As far as treatment goes in medicine, most illnesses are diagnosed and prescribed a specific solution. When it comes to weight, it has one universal solution that is supposed to work for everybody and because of this, those who fall through the average do not get the proper help that they need. It does not make sense to me to think that one single solution is universal to all people. That is almost never the case for other health problems.

    There is a graph posted in this thread that is a drastic oversimplification about the mathematics involved. Unfortunately, this simplistic outlook on the issue is only applicable to bodies which have healthy metabolisms to which counting calories is all that they need and ignores those who have other considerations to take in about their personal health queries. It also ignores aspects such as nutritional depletion in crops which have developed in places like the US over the decades, and this factors into malnutrition.

    Calories are not nutrition. While there is a correlation between calorie-dense foods and low nutrition vs. calorie-depleted and higher nutrition and it's understandable to make note of fast foods in this instance, the point stands that conventional food has far less nutrition than it used to and this in itself causes malnutrition of a different kind than simply depending on fast food. If you are malnourished on a "healthy" diet, you're still going to feel inclined to eat more than what you probably need to. From the perspective of calories, there is only eating too much or too little in order to lose or gain weight and nutrition doesn't factor in. Nutrition should factor into food sciences when it comes to weight loss. To further back this up, let's consider the glycemic index. If you eat 2,000 calories of just table sugar, it isn't going to work. To think that only calories matter is drastically oversimplified. Our digestive system is not simply a black box that only observes inputs and outputs. Nutrients matter.

    I can come up with more ways to talk about why calories are not the pinnacle of weight loss solutions.

    Another point is how calories are measured. There are two ways. One is through a bomb calorimeter where they seal the food into a container, lower it into a pool of water, and then burn it and measure how long it takes to finish burning. The other method is a calculation by man named Atwater from the 19th century. While these methods provide us some insight into calories and how much energy food has, they are old and do not factor in other aspects of digestion. You can read more about it here: https://www.livescience.com/62808-how-calories-are-calculated.html

    In the US and other countries, companies are required to label their products with nutritional facts as I am sure you are aware of. However, companies know that lower calorie labels sell better than higher ones, and as a result they bend their numbers in what ways they can. As a result of the above paragraph and this, calories are actually remarkably imprecise. But imprecise as they are, they are capable of giving us some guidance. However, the complaint that it is overdogmatized is legitimate.

    On a personal note, I found other kinds of adjustment to my food intake which helped me in the past without needing to count calories, or calories were supplemented alongside what I did and they were far better than counting calories all by themselves. I had paths in life where I did not need to count calories at all because I adjusted my food accordingly to the guidelines of other techniques. The reason I am back to journaling was actually to start making sure I was eating enough, and balanced, rather than to restrict myself. I accept that the numbers that I have are imprecise, but put me somewhere near the ballpark of where I need to be, and that is what helps me for the time being until something better comes along.

    Thank you for reading, I know this was a long post.

    edited for clarification.

    There are absolutely some parts of diet culture that frustrate me, I just don't prescribe them specifically to CICO. And to an extent I think you should 'meet people where they are at' if you want to be supportive. Calories aren't literally the only thing that matters, but if you have to focus on one thing: that's what I focus on.

    I absolutely do think some doctors will blame weight without investigating. I feel like that part has gotten better over the last decades, or maybe I just found the right doctor.

    Agreed. Meet people where they’re at to be supportive.
    Struggling with weight loss, and then getting told by strangers in an online forum that you’re “lying to yourself” and other little zingers has a serious potential to turn people away from MFP, and potentially trying to lose weight and/or get fit at all.

    As for your second point? I can assure you, blaming weight without investigating any other aspect of someone’s symptoms is still very much a thing for many doctors. It happens to women a bit more frequently, but it definitely happens to men also.
    And classism (and other isms) also is a factor in this unfortunate behavior.

    You got lucky with your doctor. And I’m glad you did. It definitely makes life easier when you have a doctor who is willing to work with you. This is not snark. I am truthfully happy for you.
  • lorib642
    lorib642 Posts: 1,915 Member
    MsCzar wrote: »


    That often is the problem and people generally try to say so politely,, 'smug' seems in the perception to me.

    You are right. I should have said 'presumptuous.' Sometimes people really do underestimate their calories, but it never sits well with me when someone automatically makes that pronouncement.
    I try to put the point as delicately as possible, but there have been studies on “diet resistant” individuals using food laced with radioactive isotopes so that the exact amount of food taken in can be tracked. One such study found that obese people who claimed not to be able to lose weight through calorie restriction were reporting on average only 1/3 of their actual intake - and this is knowing that they were being observed!

    People who are obese have had a lifetime of learning to lie to themselves and others about food and some of them have gotten so good at it that they don’t even know they are doing it. When someone says they weigh 250 lbs, work out six hours a day, and eat 1200 calories and haven’t lost a pound in six weeks, the overwhelming likelihood is dishonest logging. It’s either tell the truth or say nothing.
    Do you happen to know the name of that study? I know they tested dietitians and even they were off, but not by so much. I don’t know it is all that obese people lie to themselves and others. Calorie counting can be difficult, that is the great thing about this forum, to get advice.
  • rheddmobile
    rheddmobile Posts: 6,677 Member
    lorib642 wrote: »
    MsCzar wrote: »


    That often is the problem and people generally try to say so politely,, 'smug' seems in the perception to me.

    You are right. I should have said 'presumptuous.' Sometimes people really do underestimate their calories, but it never sits well with me when someone automatically makes that pronouncement.
    I try to put the point as delicately as possible, but there have been studies on “diet resistant” individuals using food laced with radioactive isotopes so that the exact amount of food taken in can be tracked. One such study found that obese people who claimed not to be able to lose weight through calorie restriction were reporting on average only 1/3 of their actual intake - and this is knowing that they were being observed!

    People who are obese have had a lifetime of learning to lie to themselves and others about food and some of them have gotten so good at it that they don’t even know they are doing it. When someone says they weigh 250 lbs, work out six hours a day, and eat 1200 calories and haven’t lost a pound in six weeks, the overwhelming likelihood is dishonest logging. It’s either tell the truth or say nothing.
    Do you happen to know the name of that study? I know they tested dietitians and even they were off, but not by so much. I don’t know it is all that obese people lie to themselves and others. Calorie counting can be difficult, that is the great thing about this forum, to get advice.

    I’ll see if I can find it later. If I remember it was a British study. You may be able to find it by googling some key phrases.
  • MargaretYakoda
    MargaretYakoda Posts: 1,944 Member
    edited August 1
    When someone says they weigh 250 lbs, work out six hours a day, and eat 1200 calories and haven’t lost a pound in six weeks, the overwhelming likelihood is dishonest logging. It’s either tell the truth or say nothing.

    Overwhelming, perhaps.
    But that still leaves room for some who are in fact telling the truth.

    I am good friends with one such person.
    They’ve been on a medically supervised inpatient diet for about four years now. And while they have lost some, they haven’t lost anything near what would get them to a normal BMI. And no. They’re not sneaking food. For a variety of reasons that’s impossible in their case.

    This person is native Hawaiian. Their genetics really, honest to Pete, is having a serious impact on their weight and health.

    CICO is a good rule of thumb.
    I’m never going to say that it isn’t.
    But there are differences between people.


    And I would like to see more emphasis on learning what those differences are, and how we can help people who are the outliers.

    I think it’s valid to be aware of outliers, but when someone reports hoofbeats, it’s bad practice to not at least suggest it might be a horse rather than a zebra. And I do always say that there’s a remote possibility of an outlier health issue - which can only be discovered by nailing down logging first. If the poster’s diary shows they are guesstimating portions, eating out all the time, and only logging every other day, how would anyone determine whether they were an outlier or not?

    Again, studies on obese people who believed they had slow metabolisms found that most obese people have higher metabolisms than expected. On average obese people burn more than expected, not less. They just eat a ton more food than they realize. I can’t remember the number for sure but I believe it was something like 5% of obese people in the study actually had a slow metabolism. It’s a thing but it’s an uncommon thing, not nearly as common as wishful thinking would have it be.

    I grew up with a friend whose sister had a health condition which I can’t remember the name of - she was developmentally delayed and had no off switch to her hunger. They had locks on all their cabinets and fridge because she would literally eat all the food in the house if allowed. That’s one example of a health condition which really does have an impact. Your friend has another. There are lots of meds which have weight gain as side effects. But honestly none of these examples invalidate the principle of CICO, they just complicate figuring out what the CI and CO are in that specific case. And the sad truth is that most people here don’t have a health condition making them fat, they are making themselves fat by overeating and being sedentary, which is easy to do in modern society.

    It seems to me that it would be better if instead of being punitive, saying “You’re fat because you’re a greedy pig,” we acknowledged that in a society in which the majority of people are overweight or obese, eating too much is frequently the result of quite reasonable decision making. How about, “You gained weight because you prioritized social bonds with your friends and family, and because your work requires long hours sitting down.” Doesn’t that sound better? Most people aren’t fat because they are lazy pigs, they are fat because they come home from work tired and then have to do work around the house, and because Applebee’s for some reason offers desserts containing more calories than a middle aged sedentary female needs to eat in a week. Most of us got fat because it made sense at the time.

    I don’t disagree with any of your points. And I do believe CICO is a key metric.

    I think where the split between points of view here is happening is when someone says something along the lines of “Low thyroid makes it difficult to lose weight, and easy to gain weight” and someone responds that it’s “just CICO”

    Which…. Yes? Sort of? But the thyroid condition does have an impact. In my personal case it had a huge impact.

    Low thyroid makes it very difficult to do anything. Especially if it’s really low. So yes, exercise and cutting down on calories definitely have an impact…. But when you can’t move without extreme effort? The calories are not leaving anywhere near as fast as even undereating (to a typical level based low activity, age, and height) brings them into the body.

    Have some people done that extreme effort? One MFP member reports such a thing that I have seen. And that person is the outlier. Which is good for them. But not much help for most of the people struggling with low thyroid and weight gain.

    I am a strong advocate of “meet them where they’re at”

    Yes. CICO. But also encourage people who are struggling with such issues to seek help from the medical community, and from others who have been through what they’re dealing with. A wholistic approach, if you will.

    To reiterate: Yes. CICO. But also in addition to CICO, acknowledging other individual factors is helpful, and will help people gain success with weight loss and better fitness.
  • kshama2001
    kshama2001 Posts: 25,201 Member
    @cmriverside did you read my post? I don't deny that CICO is true. I'm saying it's unhelpful to keep saying it to people over and over because we all know it. I don't have a solution, it's not my area of expertise. But the answer isn't to shrug our shoulders and dismiss the idea that it really is more complicated than that. We need more research. But you're wrong about where the problem lies. I refer to my alcoholic example again - telling an alcoholic not to drink so much doesn't help the person quit.

    As an aside, a lot of medications cause weight gain, most often by increasing appetite. The opposite is also true - Saxenda for example works for weight loss partially by decreasing appetite. Hunger is part of the problem. Humans aren't designed to ignore it. It's why most diets fail.

    There have been a few times in my life when I wasn't in charge of the menu or didn't have access to American supermarkets and I did learn to ignore hunger. It is indeed more challenging when I have unlimited access to hyperpalatable food.

    Regular posters do spend a lot of time addressing hunger issues, with two main points:

    1. We often caution against creating too aggressive a calorie deficit and I post this graphic ad nauseam:

    9kjwnia17qv9.jpg

    2. Finding the foods/macro combos an individual finds most satiating and focusing on them.

    So, CICO is key to weight loss, and dialing in one's deficit and most filling foods makes compliance easier.

    (There was a great weight loss graphic that had Compliance on 50% of a pyramid that I thought I bookmarked but didn't. If anyone has it, please @ me.)
  • HeftyLeftyNZ
    HeftyLeftyNZ Posts: 3 Member
    I had been unaware until recently of the role that insulin plays in weight loss - I had to learn that when my blood test came back with very high, diabetic level blood sugar (now successfully reversed). Once I understood that, weight loss has become easy and enjoyable (I went with a combination of intermittent fasting and very low carb/high fat diet). CICO is a hiding to nothing long term. I learned a lot from Dr Jason Fung's books - The Obesity Code, and The Diabetes Code
  • MargaretYakoda
    MargaretYakoda Posts: 1,944 Member
    If Fong is a “quack” then why doesn’t the American Diabetes Association say so when they review his book?

    https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6640893/