Do you still think it's all about calories in vs calories out and fat people are not disciplined enough ?

[deebate]

I've been doing a lot of online research over the years around diet/ exercise and what's the answer. How can I keep fit and be healthy.

I've tried various things and I am generally a believer in calories in vs calories out. Which seems to be the favoured method on here.

If anyone complains they're struggling with losing weight, it must be because they're not counting everything etc.

In any case, I've now stumbled across a number of podcasts of different doctors and nutritionists in the field talking about gut microbes and sugar spikes etc and how actually it's really not just about calories at all.

What's the consensus on here about all this ?

Well the bottom line has to be that if you consume more energy than you expend then you will gain body fat and that in order to lose it you need to be in calorie defecit. Energy can neither be created nor destroyed and all that. But I think that the physiological and psychological factors that make it possible to keep the balance are complex and do vary from person to person, and indeed for the same person throughout their lives.
Up until I was about 40 if I gained weight I could lose half a stone in a few weeks just by cutting out snacks and upping my activity a bit. It was pretty easy. Now I am in my late 50s and trying to shed the weight that I piled on during a recent protracted post operative period of immobility and it's a very different story. I still have much the same amount of will power and I've got more time to exercise but my body definitely does not behave the same way as it did 20 years ago. I feel guilty now that when I was young I assumed that losing weight was as easy for everyone as it was for me.
"Fat people are just lazy" is itself a lazy cliche and I'm ashamed and sorry that I once believed it.

For me it is CICO. I don't actually count them but years of reading labels has given me a good idea. I recently lost almost 2 stone this way, I wasn't overweight to start with but wanted to be more lean. I think people overestimate how many calories they need a lot of the time and perhaps overestimate how active they are.

The health app on my watch/phone tells me that the average person my age(30-39) walks less than 5000 steps a day on average, which is pretty sedentary . I know it won't be 100% accurate but again according to my watch I've burnt 2227 calories today, that includes going for a 10km run so just over the 2000 'recommended' amount.

Obviously there will be some outliers to that, some people on certain meds for instance but overall I think it's true, people just don't realise how much they need and how much they are eating or they do and for ever reason can't/won't cut back.

Well, I don't know you so I didn't know there were people like you out there who find your weight fluctuates dependant on CICO! 😊 I just don't know anyone who believes in it in real life except my mum who has been on a calorie controlled diet her entire adult life! Don't get me wrong I don't talk to lots of people about nutrition but the few people I do don't believe in it, my dietician doesn't and neither does my PT. So that was just my impression that it was very old hat!

When one looks at old footage of street scenes in the 1950's /1960's...everyone is slim.

''Fat'' people were very in the minority.

Look around a cot street these days, and obesity is everywhere.

Snacking is a massive culprit, I feel.

As a child {1970's} no one snacked.

Actually getting really hungry between meals was a real thing- I remember hunger a lot - Crisps and sweets were for parties or special occasions.

As were fizzy drinks.

Many people definitely had snacks in the 1970s. I was born at the end of the 70s but this was the way my parents and my grandparents always ate too.

Breakfast
Elevenses
Lunch
Afternoon tea
Dinner
Supper

3 meals and 3 snacks. I mean admittedly the snacks weren't big but they were there.

The consensus on Mumsnet is meaningless. I constantly see multiple people on here talking utter nonsense about diet and nutrition, confidently making claims that are scientifically about as valid as the notion that the Earth is flat.

In terms of weight loss, yes, it’s calories in vs calories out. When it doesn’t work for people it’s generally because they’re not calculating food intake correctly, and/or overestimating how many calories they’re burning through exercise, and/or they’ve miscalculated their requirements in the first place.

Yes I do think it's CICO. I have disordered eating passed down from my childhood, big portions, lots of bread and butter, ice creams for dessert every night, had to finish the big plate to have dessert?!?. Had to have breakfast lunch and dinner because the clock says, not because we are hungry.
It's not surprising we all have food issues in our family.

Now I eat more mindfully and won't eat for the sake of it. I'm not actually properly hungry very often and would rather have a small snack instead of a big meal.

no, please. not van Tulleken.

this man, who has no training in food science, nutrition or dietetics (or even gastroenterology or endocrinology) has tortured scientific evidence, which he misunderstands, to fit his weak but seductive narrative, all on the back of being medically trained.

i find it sad that so many people fall hook and sinker for these theories - book writers are grifters flogging magic bullets and living off the pricey public engagements they get on the back of their book deals

I think it depends on what you regard as a snack.

My parents still have the same rigid 3+3 meal schedule as yours with a snack being more of a light meal eaten at the table than a packet of crisps or a bar of chocolate.

It absolutely is calories in calories out. I got very sick last year and couldn't eat much and lost weight. After years of kidding myself on every diet possible, I lost weight easily when I was... eating a lot less.

No I dont.

Sugar is what is converted to body fat. Lowering the carb intake works far better.

But......the idea that carbs "fill you up" and stop the hunger is a hang over from the war. Potatoes, bread etc kept the hunger at bay when food was scarce. The next generation grew up with carb heavy dinners and with little meat (the mumsnet chicken really was a thing for my mother and grandmother). The idea that you ate more carbs and less fat was because you didnt feel hunger and that was good. Also protein in a "traditional" diet is expensive. Better to have a mumsnet chicken and a pile of spuds than chops, bacon, etc every day. It feels counterintuitive.

My father has embraced low carb and it has reversed his pre-diabetes, mother still doesnt really accept it. But she has 50 odd years of "slimming", of avoiding high fat, of depriving herself thinking she would be slimmer and cant get her head around the idea that a plate of steak and eggs will have her losing weight instead of the plate of plain pasta making her put weight on.

Depends what you normally eat though.

Low carb isnt a diet, its simply cutting down on what you dont need. But it feel counterintuitive because for the first couple of weeks you do feel hungry as your stomach and brain are used to that feeling you only get after a lot of bread or potatoes or rice or pasta. Cut down on anything high sugar. Take those away and it takes a couple of weeks to get used to it (carb flu) but then the result are eye opening.

Low fat yoghurts have higher sugar levels then full fat.

High fat low sugar is a better and more natural way to eat than the other way around.

Oh nooooo! Don’t say that - I’ve just ordered CvT’s book because everyone seems to be raving about it 😂

I used to think it was as simple as calories in vs calories out, but when I reached menopause I piled on the weight and no amount of calorie restriction or exercise has been able to shift the body fat for me.
So for some people yes it is simple, but for many it's just not that basic.

I have been many weights and tried many diets. I lost 5 stone in lock down and kept it off, after having lost 3 stone here or 2 stone there and putting it back on again. The 5 stone has been off 4 years now and while I did CICO to lose, I don’t do CICO to maintain. I have PCOS too so there is an insulin measurable here but I am sugar free now and that has helped MASSIVELY.

I find that I naturally regulate CICO now. I don’t eat pasta much as I just inherently know that the same size bowl of pasta vs a bowl of broccoli will be 5x the calories and the broccoli will be better for me. I just eat a larger portion of the better food. It’s CICO but people might call it “low carb”.

Snack? I choose better. Not just in calories but in health. I might have a bowl of melon vs a bag of crisps. I could (but can’t) eat half a melon vs one bag of crisps.

And so it becomes CICO without trying but people will call it “intrinsic eating”.

Most diets boil down to CICO except things like keto depending how you do it, but the measurable there will protein macros. I found on that diet that I ate fewer calories too btw.

I agree that hormones to play more of a part for women than men.

I ate less during all my pregnancies than I did before or after, yet still piled on weight. I know a lot of women with very healthy diets and active lifestyles that chunked up during menopause and struggled.

I still maintain that low carb is the better way to eat but......when men write these "I have found the secret to weight loss!!" books, they fail to take into account that in general mens bodies dont change so much as womens over their life time. Yes they get old and slow down, as do we, but they dont have to deal with the hormonal ebb and flow like we do. When we are young we are biologically predisposed to stay healthy enough to conceive, then when pregnant our bodies lay down stores to see us though labour and breastfeeding, then meno happens and we need stores to see us though old age.

We are still, evolutionarily speaking, barely half a step away from our prehistoric sisters. They had intermittent food and still had to go through all of that. Our bodies simply havent caught up with the abundance that we have. Our cells are still at that "oh food!!! HANG ON TO IT!!" stage that they were several thousand years ago.

When a man says "Here is a simple way to lose weight" I dont read any further because he has no fucking idea what womens bodies go through.

It's definitely not as simple as eating more or eating less. For one thing, if that were so then things like antidepressants, progesterone, steroids, low thyroid levels, stress, and other medical fluctuations wouldn't lead to weight gain, yet there is unambiguous statistical evidence that they do even when eating patterns haven't changed. For another thing, some people genuinely feel hungrier all the time or seem to have more taste for more fatty or sweet foods: and chemical changes, including taking Ozempic and Wegovy, as well as bariatric surgery, which takes out receptors on the stomach lining, are proven to affect those appetites. The newspapers reported quite recently that scientists have identified a gene that makes its owners six times more likely to be obese, though they're not sure whether the gene affects appetite, metabolism, or something else https://www.telegraph.co.uk/news/2024/04/04/fat-gene-found-makes-adults-six-times-more-likely-obese/

Furthermore, eating less is not simply a matter of exerting virtuous self-control. Diet is noticeably affected by cultural norms, by what's available, and by who you eat with, from family to friends. Eating is key to our social lives: it's hard to be friends if you never eat lunch with your coworkers or stop by the takeaway with your classmates after school. It's impractical to cook separate foods every day for different people at the same family meal. And I for one find it nigh impossible to sit just twiddling my thumbs and watching while others at the same table are forking in a tempting cake! Weight patterns run in families, which could be genetic or learned or just shared habits, most likely all of those: in fact, people tend to gain weight if they spend more time with friends who are heavier. https://www.nytimes.com/2007/07/25/health/25iht-fat.4.6830240.html

Exercise uses up far fewer calories than you would hope -- it would take 88 minutes of brisk walking to offset four McVities chocolate digestives: www.nutritionix.com/i/mcvities/digestive-dark-chocolate/582026e1127741c124c7e5ba
Conversely completely unconscious and unintentional, biologically-determined fidgeting has been proven to account for as much as 40lb of weight loss in a single year: https://www.nytimes.com/2005/01/28/health/the-fit-tend-to-fidget-and-biology-may-be-why-a-study-says.html

There is also so much evidence that, despite how amazingly wide the "healthy" BMI ranges are, some population groups get weight-related diseases like diabetes and heart attacks at lower BMIs than others. Eg. South Asian and African ethnic groups are recommended to keep their BMI below 23, while the rest of us are told up to 25 is ok; men, post-menopausal women, and everyone else with an tendency to pack the weight on their belly instead of their hips, are more likely to have heart attacks at the same BMI. (This is the main reason women have a longer average life expectancy than men.)

But also, I am continually baffled by the way calories are defined. For more than a hundred years calories in food have been "measured" by literally burning the food. Despite the way people talk about "burning" calories through exercise, there is obviously not a little fireplace in your gut, and it is very clear different people digest foods differently. (TMI here, but when we eat corn/maize at home, DH finds it comes out the other end visibly unchanged, while you can't tell what I ate.) I guess this is where all these theories about "gut biome" stem from, but there's not yet clear evidence on how genetics, diet, medications, exercise, and other unknown factors change your gut biome (despite what the probiotic manufacturers claim in their adverts).

I'm a lifelong skinny, like everyone in my family, and it has always been very clear to me that this is not because I eat better or exercise more than other people. I am lazy as heck and eat huge quantities of chocolate daily. I'm just lucky.

I think 90% of the time its calories in vs calories out....but that other 10% does exist!
I know from personal experience. I struggled to lose weight for decades. Massive binge eating problem, felt awful and couldnt lose weight no matter how big a calorie deficit or how much I exercised. Then menopause started and I felt even worse.
Eventually I got diagnosed with a severe vitamin D deficiency and after that got fixed I actually started losing weight. Also came to realiese that I probably had PMDD for most of my life as my binge eating disorder just vanished with meno!
So went from struggling to lose any weight at all to easily losing 7st over a year and a half!

CICO has got to be the most influential factor in weight management. I think the biggest variation between individuals though is appetite.

Until I breastfed my first baby I had absolutely no understanding around why some people I knew would eat large amounts of food quite quickly. Suddenly, I was starving and I could totally empathise that this must be how they felt. This was the first time in my life that I had experienced such a huge appetite. The same thing happened to me when I took Sertraline.

Unless it’s water weight, it’s calories in vs calories out. It’s physics. But it’s not just about self control. I think there is a huge variance in appetite among people, not to mention how things taste. If you’re someone that’s doesn’t get hunger cues often, you could eat as much as you like and be thin. Because your body isn’t telling you to eat much. (I’m like this but for thirst. I very rarely feel thirsty and can go a full work day with no real liquids. I am dehydrated, but I don’t feel thirst so I don’t realize I’m dehydrated. For sure there are people like me, but with hunger cues).

And taste is different. Obviously. If it wasn’t, we would all like and dislike the same things. I suspect that for some people who are generally uninterested in food, things just probably don’t taste that great to them.

So people with naturally smaller appetites, low hunger cues, or weird taste buds might eat less, but it’s not that they have more self control per se.

There's always a long stream of MNers insisting that because they have normal, predictable, optimally-functioning bodies, everyone must be the same as them. CICO works as expected for them, so it must do for everyone else. It's as though hormones, medications and illnesses never make bodies malfunction ... which is a strange attitude.

There are things like this:

Lipodystrophy syndromes are a group of genetic or acquired disorders in which the body is unable to produce and maintain healthy fat tissue.

Cachexia is a complex syndrome associated with an underlying illness, causing ongoing muscle loss that is not entirely reversed with nutritional supplementation. A range of diseases can cause cachexia, most commonly cancer, congestive heart failure, chronic obstructive pulmonary disease, chronic kidney disease, and AIDS.

Genetic factors are not trivial, as mentioned by @athingofbeauty just now, and neither are hormones. It's not only fertility-related hormonal changes, although those are cataclysmic for many of us, but also things like pituitary, adrenal, thyroid, pancreatic hormones (and the rest). Our hormonal profile's a deeply complex, interdependent messaging system. One change affects the others and women's change all the time.

It's absurd to protest that a dynamic, living biochemical system is the same as a combustion engine.

In the same way, medications don't just make you more or less hungry - many of them are prescribed for their far-reaching effects on our biochemistry and their ability to activate or block hormone receptors throughout the body. Medicine can't yet target them to have one effect but no others - that might not even be wise - so, of course, some can make our bodies pile on weight or lose it.

I can't be bothered to make a list of diseases & conditions known to make people's bodies accumulate flesh so intensively that they couldn't diet it away without suffering malnutrition, or refuse to accumulate it so that additional food causes liver failure.

Of course some version of CICO will work for most people at least some of the time, and of course it's worth experimenting to find out what works best for you. It's just massively annoying when people flatly deny that it will not always work for everyone. There's plenty of evidence that it's way more involved than so-called experts want to believe.

FWIW my BMI is 25, up from 21 since starting antidepressants and, simultaneously, menopause. I may have just escaped "overweight" but I can see I've got a lot more visceral fat than I had at the same weight in my thirties. This appears to be my "set point" nowadays - it might go back down if I stopped the antidepressants but, then, I'd be stuffing sugar in my face to stave off the suicidal feelings! I'll take the meds and the doughy midsection 😏

Great post, @athingofbeauty.

To lose weight effectively you need to be in a calorie deficit, ie, burning more calories than you eat (not sure if that's what you mean by calories in, calories out?)
So, I'm of the understanding that it doesn't matter what you eat necessarily; just that you are burning off more than you consume.
That said, it's of course always best to make healthy choices while trying to lose weight. I wanted to lose weight recently and this what I did:
As well as generally eating less and moving more, I also largely follow a wholefoods, low carb, high protein diet - protein really is your friend here as it digests slower than fat, meaning your body tackles fat stores first!

I don't drink alcohol anyway and I've cut out caffeine, refined sugars and heavily processed foods. Oh and I'm drinking at least three pints of water a day.

As a result, not only have I lost the weight I wanted to but I feel and look better than ever. Inside and out.

If it were as simple as 'CICO' then no one would be overweight.

So obviously it isn't that simple, but that doesn't mean that CICO isn't a factor.

To lose weight, I need to eat at a HUGE calorie deficit - around 600 - 800 cal a day will see me lose weight. 1000+ will not.

If I were to get those calories from chocolate bars, my insulin intake as an insulin dependent, insulin resistant Type 2 diabetic would mean I would put on weight, a lot of that weight would be water and lymphatic fluid, but tbh it doesn't matter if the weight is fat, water, lymph or bloody fairydust, it is still weight, it is still causing my body to struggle to function.

Some people can easily eat at a calorie deficit without feeling hungry, and choose from a wide range of foods to do so. They will be those who rarely need to lose weight or can just decide 'oops, ill rein it in a bit' for a few weeks and those few extra lb drop off.

Some of us will never do that, and the amount of willpower we'd need and the misery we'd experience would be beyond belief to the former type of person.

If your gut is optimal, you can eat a wide range of foods, your body functions the way it should, you can move around and do... then a simple calorie deficit will serve you well.

But many peoples bodies are NOT functioning anywhere near optimally and they won't know this - they've not (yet) got any sort of useful DX, because in real terms what the NHS actually knows about gut function could be written on a fucking postage stamp - so they'll trundle on believing that they can't lose weight, struggling and having a fucking miserable time.

For most people yes. I went with all this "must be my metabolism fucked", "must be this and that, I eat healthily" "calorirs are bullshit" "BMI is wrong". Only when I finally stop being in denial andlooked at calories I lost. There are few genuine exceptions medicallybut most of population, yes, in and out balance.

I live in a country where the majority are slim. Regular balanced meals with set snack times and no eating inbetween. Less use of cars. Culture of movement from the word go, i.e. from Kindergarten. That's it.