The conventional weight-loss advice to eat fewer calories carries an estimated failure rate of 99.4%. For morbid obesity the failure rate is 99.9%
So what happened? Why does this fail? Are we not following the advice given ? Or is this advice wrong ?
One thing the calories-in vs calories out model assumes is that the basal metabolic rate stays constant. But a 40% decrease in calories can also be met with a 40% reduction in the basal metabolic rate. We are not like goldfish, that we cannot control how much we eat. Similarly, when we eat less, the body has many survival mechanisms; it won't keep burning the same amount of fuel. It will downregulate fuel burn, so that we may survive. Calories in - Calories out simply ignores this fundamental physiology of our inbuilt survival mechanism.
The thyroid, respiratory, circulatory, hepatic, renal, gastrointestinal, and adrenal systems are all closely regulated by hormones. Body weight and body fat are also strictly regulated by hormones, with multiple overlapping systems of body weight control. Body fat, one of the most important determinants of survival in the wild, is simply not left to the chances of what we put in our mouths.
So what controls body fat accumulation ?
Fat accumulation is not simply a problem of eating too much. It also is a problem of energy distribution. If energy is diverted to storing fat vs burning fat, we will accumulate fat. How is this controlled - hormones.
We cannot "decide" to feel less hungry, or to increase our metabolic rate. If we eat fewer calories our body will often decrease the metabolic rate. So if calories are not the main reason for weight gain, how can you reduce weight by eating less calories? The most important factor for controlling weight is controlling the hormonal signals we receive from the food, not the total number of calories.
Obesity is a hormonal imbalance, not a caloric one. As we see in diabetes, when we prescribe insulin we usually see weight gain. The no.1 side effect of the drug prednisoneis weight gain. Anti-biotics cause weight gain (and why they are used in animal meat production).
Thus, obesity is a hormonal imbalance, not a caloric one. Thus, type 2 diabetes can also be called a disease of insulin imbalance rather than caloric imbalance.
This blog post is part of my series looking at Dr Jason Fung. A leading nephrologist and author who is changing how we look at diabetes.
The Life Heal team explores the emerging science of weight loss and disease reversal with a special focus on Diabetes. We discuss nutrition, food and ways to become healthy