Toilet Humor And The HOW vs. WHY Of Getting Fat

You ever go to a big party, go to the bathroom, flush the toilet, and the water starts coming … up? This is the most frightening moment in the life of a human being. You’ll do anything to stop this. You’ll lose your mind and start talking to the toilet: “No, please, don’t do this to me. No, come on, you know this is not my responsibility! I didn’t make this happen!” – Jerry Seinfeld

Of course you caused it to happen, Jerry. You flushed the toilet, which filled the bowl with water. More water went into the bowl than went out, and so it overflowed. Call any reputable plumber and ask why a toilet overflows, and that’s the answer you’ll get: more water going in than going out.

Heh-heh-heh … just kidding. A reputable plumber would explain that something has clogged up the system, then charge you a hefty hourly fee to fix the clog.

Back in my standup days, I opened a few times for a comedian I really liked named Tom Parks. He had a good bit about his toilet backing up into his bathtub. (I don’t remember it word for word, and paraphrasing won’t be as funny. Sorry about that.) Parks called a plumber, who fixed the problem and then apologized for the bill, explaining that house calls on a Sunday are billed at two-and-a-half times the usual rate … to which Parks replied, “Buddy, here’s all I want to know: is the @#$% gone from my tub? Yeah? Then you can charge me whatever you want.”

Fortunately, the plumber didn’t attribute the problem to more @#$% entering the tub than exiting.

I bring up the toilet humor because of yet another raging debate about the relevance of calories-in/calories-out (CICO) on the Fat Head Facebook group. I don’t have time to read all the posts in the Facebook group, much less comment on them, but I did chime in on that one. Here’s what I wrote:

Arguing about whether weight gain/loss is caused by the hormonal effects of diet or CICO is like arguing whether your toilet overflowed because of a clog in the pipe or because more water went into the toilet than went out. CICO always applies, but that’s the HOW of the result, not the WHY.

I’m not sure why this is such a difficult concept for some people to wrap their brains around, but apparently it is. So I’ll try to explain one more time:

Those of us who believe losing weight isn’t as simple as restricting calories aren’t denying the laws of physics. People have accused Gary Taubes of ignoring the laws of thermodynamics, but frankly, that’s beyond ridiculous. The man has a degree in physics from Harvard, for pete’s sake. His first award-winning book was about physics. It seems rather unlikely that when he wrote Good Calories, Bad Calories, he just up and decided the laws of physics don’t apply to obesity or weight loss.

What he’s tried to explain in at least a couple of speeches I watched online is that yes, of course, if you increase your body mass, you consumed more calories than you expended. If you decrease your body mass, then yes, of course, you expended more calories than you consumed. But that’s all the calories-in/calories-out equation can tell us. It doesn’t tell us the actual reason weight gain or weight loss occurred.

As I was trying to get across in my Facebook comment, we’re talking about the difference between HOW vs. WHY. If my toilet overflows, then yes, more water entered the bowl than exited. That’s HOW it overflowed. But that’s not WHY it overflowed. The WHY would have something to do with a clog in the pipes.

People who insist that gaining weight is caused by consuming too many calories and that losing weight is therefore as simple as consuming fewer calories are confusing HOW with WHY. The HOW of gaining or losing weight is always the same: a calorie surplus or a calorie deficit. But that doesn’t mean eating more will make you fat or eating less will make you thin.  Your body is rather opinionated about how much fat mass it wants to maintain and will adjust your metabolism accordingly.  That’s where the WHY comes into play.

In his book The Calorie Myth, Jonathan Bailor wrote about a group of research subjects who consumed an extra thousand calories per day for several weeks. According to the CICO equation, they should have all gained 16 pounds. Nobody gained that much (the most anyone gained was eight pounds), and some of the naturally-lean subjects gained a mere half-pound. So let’s look at HOW vs. WHY for those lucky people:

• HOW they avoided getting fatter: the calories they expended matched the calories they consumed.
• WHY they avoided getting fatter: their bodies are hormonally geared to stay lean and responded to the extra calories with a corresponding rise in metabolism.

Here’s a paragraph from Good Calories, Bad Calories:

When physiologists began studying animal hibernation in the 1960s, they again demonstrated this decoupling of food intake from weight gain. Hibernating ground squirrels will double their body weight in late summer, in preparation for the winter-long hibernation. But these squirrels will get just as fat when kept in the laboratory and not allowed to eat any more in August and September than they did in April. The seasonal fat accumulation is genetically programmed – the animals will accomplish this task whether food is abundant or not.

So simply limiting food intake didn’t prevent the calorie-restricted ground squirrels from getting just as fat as their free-eating brethren.

• HOW they got just as fat: they consumed more calories than they expended.
• WHY they got just as fat: hormones released before the hibernation season commanded their bodies to get fat, and their bodies heeded the command … even if doing so required a drastic reduction in metabolism to provide the surplus calories to store as fat.

Here’s another paragraph from Good Calories, Bad Calories:

In these experiments, researchers remove the ovaries from female rats. This procedure effectively serves to shut down production of the female sex hormone estrogen (technically estradiol). Without estrogen, the rats eat voraciously, dramatically decrease physical activity, and quickly grow obese. When estrogen is replaced by infusing the hormone back into these rats, they lose the excess weight and return to their normal patterns of eating and activity.

Oops. I guess getting fat is all about eating too much and exercising too little after all. Those rats ate voraciously and sat around being lazy. That must be why they got fat.

But wait …

When researchers remove the ovaries from the rats, but restrict their diets to only what they were eating before the surgery, the rats become just as obese, just as quickly; the number of calories consumed makes little difference …. “If you keep the animals’ food intake constant and manipulate the sex hormones, you still get substantial changes in body weight and fat content,” [researcher George] Wade said.

• HOW the rats got fat: they consumed more calories than they expended.
• WHY the rats got fat: removing their ovaries caused a hormonal imbalance that commanded their little rat bodies to accumulate fat – which they did, despite no increase in food intake, probably by drastically reducing metabolism.

Awhile back, I watched a TV documentary called The Science of Obesity. It wasn’t very good overall, so I didn’t write about it. But there was one intriguing section about a woman who was lean her entire life, then became morbidly obese within a year. She limited herself to 1500 calories per day, but didn’t lose any weight. Her doctor insisted she was lying about her food intake.

So she did the smart thing and found another doctor – who ran a slew of tests and found she had a tumor on her pituitary gland. Was she consuming more calories than she was expending while becoming obese? Yup. Gaining weight always requires a surplus of calories.  Does that mean she got fat and stayed fat because she was eating too much? Nope. She became obese because of the tumor, which caused all kinds of hormonal hell to break loose.

I recently had a good friend tell me he finally cut way back on his carb intake, especially his bread intake. (Interestingly, he wasn’t persuaded by Fat Head to change his diet; it was a personal trainer who finally got through to him.) He’d been eating less and less over the years in a failed attempt to drop some weight. I remember hanging out with him over a weekend, and he didn’t eat anything until dinner – but then bread was the first item on his dinner menu. Bread, a salad, and some salmon. That was it.

Anyway, after making the dietary change, he told me, “I swear, I didn’t do anything but ditch the bread and potatoes, and 15 pounds just dropped off like nothing. I was never hungry. I never felt deprived.”

• HOW he lost weight: he expended more calories than he consumed.
• WHY he lost weight: a change in diet triggered some kind of hormonal shift that moved him from fat-accumulation mode to fat-burning mode.

Maybe he unconsciously ate less, even though he insists he didn’t. Maybe he started releasing fatty acids at a faster rate and didn’t feel hungry because he was eating his own fat. Maybe he started eating more protein, which requires more energy to digest. Maybe his metabolism perked up. Doesn’t matter. The point is, something about the change in diet fixed the WHY of his inability to lose weight. He absolutely, positively expended more calories than he consumed while losing … but he didn’t count calories or consciously restrict his portions in order to do so.

When we switch to a better diet and end up losing weight (and keeping it off) for the first time in our lives, it means we’ve finally addressed the WHY of excess fat accumulation. The HOW of weight gain (whether we gain fat or muscle) is always the same:  consuming more than calories than we expend. CICO and hormones are not mutually exclusive explanations, any more than a clogged pipe and water-in vs. water-out are mutually exclusive explanations for an overflowing toilet.

I don’t like the CICO explanation because 1) it doesn’t actually tell us why a person gains or loses weight, and 2) it encourages people who don’t know what the @#$% they’re talking about to be judgmental — like that idiot reality TV star from England who stuffed herself to get fat and then concluded that fat people just eat too much.

But in a recent email, a reader reminded me that people who attribute obesity to hormones can be judgmental too … or least too confident that they understand the WHY of weight gain and have the answer.

This woman has been overweight for years.  She’s tried everything under the sun, including severe calorie restriction.  When people told her “it’s the hormones, it’s the hormones, it’s the hormones!” she had everything checked and checked again, by endocrinologists, holistic practitioners, you name it.  The bottom line is that she can’t lose the excess weight, and nobody can tell her why.

I’m reminded of the “resistant obese” subjects some researchers described in a study I recounted in a previous post:

This phenomenon of people who do not lose weight is really the most tantalizing thing that confronts physicians.  There are these people who can live on 600 calories and not lose any weight. On what are they surviving?  If we measure their basal metabolism in terms of calories, we get figures in excess of 600 calories per twenty-four hours.  It would seem that on this diet they are in a caloric deficit all time, but still are not losing any weight.  I am still an admirer of the laws of thermodynamics, but these people seem to be thermodynamic paradoxes.

The researchers were describing people under supervision in a hospital.  They weren’t sneaking food or lying about their food intake in a diet journal.  They were locked down in a hospital, but failing to lose weight on 600 calories.  I don’t think they were thermodynamic paradoxes, however.  Somehow, some way, they managed to get by on that ridiculously low intake of food.  Some people just seem to be hard-wired to be very fat.

• HOW they stayed obese on 600 calories:  The calories they expended matched the calories they consumed.
• WHY they stayed obese on 600 calories:  Nobody knows.  And nobody should judge them for it.  Those unfortunate people are just proof that scientists still have a lot to learn about the WHY of obesity.