The Calorie Debate … Again (and again and again?)

Calories. Sheesh, here we go again. Apparently it’s the debate that will never die. Hardly a week goes by without yet another calories count vs. no it’s all about hormones dustup on the Fat Head Facebook group. I’ve addressed the topic many times, but I’ll give it another whack.

In online debates, people seem to take one of two positions: 1) gaining and losing weight is a simple, linear function of how many calories you consume, or 2) calories have nothing to do with gaining and losing weight.

I don’t subscribe to either position.

Hundreds of people have emailed me over the years to tell me after watching Fat Head, they finally lost weight after years of frustration with low-fat/low-calorie diets. I’m grateful for that. But in case you’ve forgotten (or never saw the film), here’s what I said before starting my fast-food diet:

So here’s my plan: using my functioning brain, I did a few minutes of research and found that a man of my size and activity level burns about 2500 calories per day. To create a calorie deficit, I’m setting a target of 2000 calories per day. I’ll also burn a few extra calories by walking six nights per week instead of my usual three. But, here’s the really important part: To make sure my body can burn its own fat for fuel, I’m going to keep my insulin down by limiting my carbohydrates to about 100 per day.

I didn’t pull that plan out of thin air. While researching diets, health and weight loss online, I came across a few posts by some doctor named Mike Eades that made perfect sense. I wasn’t previously familiar with him, so before getting in touch to ask about a possible interview, I read both Protein Power and The Protein Power Lifeplan, the books he wrote with his wife, Dr. Mary Dan Eades.

Both books were very enlightening. I finally understood why I’d failed to lose weight on low-fat/low-calorie diets full of hearthealthywholegrains! and other garbage carbs: I was trying to restrict calories while eating foods that were signaling my body to store fat. When you fight your own body, your body wins. If you want your body to cooperate, you need to get into a hormonal state where it’s willing to burn away stored fat. But willing to burn stored fat isn’t the same as has a need to burn stored fat.

Here’s a quote from Protein Power (bold emphasis mine):

Try to make it a habit to keep good records of what you’re eating, how much you exercise, and how you feel. Having an accurate written record also gives you some hard data to look at if you hit a plateau. Are you simply eating too much? Have you missed exercising regularly?

Protein Power includes a formula for guesstimating your daily protein requirement. Mine came out at around 120 grams per day. Later in the book, there are instructions for moving out of the initial (very low-carb) phase, through a second phase, and finally to a maintenance phase:

Increase your daily carbohydrate intake in 10-gram increments until you reach an amount approximately equal to your daily protein intake – e.g., if your daily protein intake is 75 grams, increase your daily carbohydrate gram total from 55 grams (the Phase II level) to 65 grams and finally to 75 grams.

Protein and carbohydrate roughly in balance … yeah, that sounded good.  So as someone who walked six miles several nights per week, I chose a target of 100 grams or more of protein per day, plus around 100 grams of carbohydrate. Yes, that’s more like a maintenance phase, but I was pretty sure that would get me into a hormonal state of willing to burn fat. Then I chose a target of 2,000 calories to create the need to burn fat.

Here’s another quote from The Protein Power Lifeplan (again, bold emphasis mine):

There are basically seven methods we use in our practice to improve insulin sensitivity, and all the but the last are part of the Protein Power Lifeplan:

1. Decrease carbohydrate intake
2. Decrease calorie intake
3. Exercise
4. Alter the dietary fat profile
5. Supplements
6. Deplete the body of excess stored iron
7. Medications

And later in the same chapter:

Carbohydrate restriction actually aids in the calorie-restriction process. A number of studies have demonstrated that when presented with unlimited quantities of foods containing high, moderate, or low amounts of carbohydrates, the group given the high-carbohydrate foods will eat more calories than the group given the low-carbohydrate foods …

And finally, here’s a quote from one of Dr. Eades’ blog posts, which he forwarded to me today in an email:

Although the lowered insulin and elevated glucagon open the doors to the fat cells allowing fat to come out to be burned, the fat comes out only if it’s needed. If you are meeting all your body’s energy needs with the food you eat, the body doesn’t need the fat in the fat cells. On a low-carb diet your body burns fat for energy. But it doesn’t care where this fat comes from; it can come from the diet or it can come from the fat cells or it can come from both. If you are consuming enough fat to meet all your body’s requirements, your body won’t go after the fat in the fat cells no matter how severely you restrict your carbs. You will burn dietary fat only and no body fat. And you won’t lose weight. It’s that simple.

That’s a pretty far cry from calories have nothing to do with it, wouldn’t you agree? That’s why you won’t see me melting a stick of butter into my morning coffee. I don’t see the point. It’s not going to help with weight loss unless you’re still creating a need to burn body fat by restricting elsewhere. I’d rather eat a few eggs for breakfast and get some protein into the equation.

But wait … haven’t I written a bunch of posts trashing the CICO theory? Why yes, I have.

My beef with the CICO crowd is that they’re constantly pushing a belief that simply isn’t true: namely, that our bodies work like simple bank accounts, with calories substituting for dollars. Cut 500 calories per day from you diet, and by gosh, you’ll automatically burn away one pound of fat per week. Cut 1,000 calories per day from you diet, and by gosh, you’ll double the fat loss to two pounds per week. Start eating an extra 500 calories per day, and by gosh, you’ll automatically gain a pound of fat per week, etc., etc. All based on simple, predictable, linear math.

In the Fat Head Kids book, we call that The Piggy Bank Theory. There are reams of evidence that it simply doesn’t work in real life. We mentioned some of that evidence in the book. You can read up on more of the evidence in The poor, misunderstood calorie by Dr. Bill Lagakos or The Calorie Myth by Jonathan Bailor.

The Piggy Bank Theory doesn’t work because it ignores the fact that the calories-in side of the equation affects the calories-out side of the equation.  Or to stick with a banking analogy, it ignores the decisions made by an account manager who controls all your spending and receives a constant stream of instructions from the bank — many of which are determined by what kind of currency you deposit, not just how much. (I used the account-manager analogy in an early draft of the book before switching to the biological-spaceship analogy.)

If the account manager has instructions to increase your savings account, she’ll probably start by sending you messages demanding bigger daily deposits. But if you refuse, she’ll turn down the thermostat to spend less on fuel. She’ll cancel the daily repair jobs to spend less on construction. Then she’ll take the savings and put them in your account.

Or if the account manager is under orders NOT to increase the size of your account even though you’re making bigger deposits, she’ll ratchet up spending. She’ll turn up the thermostat to spend more on fuel. She’ll spend your extra deposits by hiring construction crews to tear down and rebuild portions of the building, then do it again. She might even take some of the dollars you deposit and flush them down the toilet.

That’s why Piggy Bank math doesn’t work in real life. The account manager receives and follows instructions we can’t control simply by depositing fewer dollars. But that’s not the same as saying the number of dollars you deposit has nothing to do with the size of your savings account.  Of course your deposits affect your balance.

That doesn’t necessarily mean you have to count calories. Lots of people find that when they ditch the sugars and processed carbs, or go full-blown ketogenic, they finally lose weight after years of frustration and failure, even if they’re not counting calories. That’s because the change in diet changed the instructions sent to the account manager. She was informed that it’s okay now to start draining dollars from the savings account. So she kept the spending high and/or requested fewer deposits.

But once again, the fact that many people on a low-carb diet lose weight without counting calories doesn’t mean everyone on a low-carb diet will lose weight without counting calories. Here’s another quote from The Protein Power Lifeplan:

Patients come into the clinic or send us their diet diaries indicating that they have been keeping their carbohydrate intake within the prescribed limits or even lower, and yet they haven’t been losing weight, and they want to know why. We question them or look at their diaries and often find that they have indeed been keeping their carbohydrate intake low but at the same time have been eating enormous quantities of food.

The book goes on to describe how quite often, people eating these large quantities of food didn’t lose weight, but also didn’t gain. Dr. Eades mentioned that again in an email:

If people are extremely calorically restricted, they do about the same on any diet, because the body is using everything coming through the mouth.  Where it gets interesting is at the other end of the spectrum.  When people go on rigid low-carb diets, but overconsume calories, they don’t really gain weight.  They don’t lose, but they don’t gain, either.  Somehow the low-carb diet really ratchets up the energy expenditure when low-carb calories are high.  I’ve seen this in patients (as has MD) innumerable times, and I’ve had a number of readers write to tell me about it.

We know that’s not true for everyone, but it’s certainly been true for me. In fact, that’s what I consider the real gift of a low-carb diet: the resistance to weight gain. I’ve gone on cruises and eaten like a king for a week … bacon and sausage and eggs with hollandaise sauce, meat-and-vegetable salads with bleu cheese dressing, steaks and lobsters and shrimp cocktails, and plenty of butter with everything. Then I step on the scale at the gym when I get home and find I haven’t gained an ounce. Love it.

But that’s not the same as losing weight. So to wrap up, let’s return to The Protein Power Lifeplan:

We can take home a couple of lessons from this example. The first is that although cutting carbohydrates doesn’t necessarily mean you will lose a lot more weight than you would on a high-carbohydrate diet of equal calories, it does mean that if you eat a huge number of calories in low-carbohydrate form, you will be prevented from gaining the weight you would on a high-carbohydrate diet of the same number of calories. The second lesson is that if you want to lose weight, you have to watch the calories – even on a low-carbohydrate diet – particularly if you’re a small person…. To lose weight, you’ve got to create an energy deficit.

Hormones, not calories, determine whether your body wants to burn fat or store fat. But even when your body wants to burn fat, you still have to give it a reason to raid the fat stores.  Some people begin burning and/or excreting more calories than they consume automatically when they go low-carb or ketogenic.  But some people don’t.  I’ve heard from plenty of people who had to combine carbohydrate restriction with some degree of calorie restriction to finally drop the pounds.

So please, let’s stop insisting nobody has to count calories.  It simply isn’t true.