The Calorie Talk Taboo

For a fair number of people, talking about calories is akin to blaming the victim; the implication of sloth and gluttony, being lazy or pigging out - blame heard without words spoken (or written).

This comes from, I believe, decades of a message from experts - that if the overweight and obese would just eat less and move more, they'd lose weight.  If only it were that simple!

A few years ago I wrote about this in Poor Math Skills Leading to Weight Gain and noted,

"We're repeatedly told that we suffer mindless eating habits, a toxic food environment, and a host of other influences which lead us to overeat; all of which can be overcome if we simply set our minds to choosing foods wisely, strictly rationing our intake with portion control methods, and sticking to recommended intakes of each food group to target particular ratios of calories from carbohydrates, proteins and fats.

When doing these things fails to produce long-term weight management, the individual is often the target of blame - they failed by failing to follow the recommendations. They failed to have adequate willpower to continue as directed. They failed to restrict calories sufficiently enough for the long-term to maintain weight effectively.

Rather than challenge the concept - consciously restricting food intake - we instead accept that such is normal and focus on the failure as an execution problem by the individual, often stated many different ways, but always boiling down to calories in exceeding calories out if the individual could only get it right then all would be well.

This makes weight loss and management a math problem.

In order to lose and maintain weight one must then be good at math in order to be able to constantly be vigilant in counting their calories in each day to keep consumption within target outputs.

So, maybe it isn't willpower, but poor math skills leading to long-term failure to maintain weight loss?

No, I don't really believe that...but, it does open the door to consider the idea that weight isn't simply a math problem that is easily solved by changing inputs and outputs of numbers; that in the long-term exerting will to restrict calories over desire to eat is not really all there is to successful weight management."

I wrapped up with "Weight is chemistry.  Chemistry thus influences obligate requirements for nutrients and energy, as well as our ability to exert our will over our desire."

Over the years, I've noted that while those who initially follow a low-carb diet do not need to count calories, calories do count - in context.  The context is physiology, the chemistry within our metabolism which is driven by our endocrine system.  It isn't simply a math problem to calculate input of calories and output of energy expenditure - it requires actual nutrients within the context of those calories because a calorie is not a calories in our body - a sugar calorie acts differently in our body than a fat calorie.  Context.

And while I've made it clear that blaming the victim is an unscientific approach to resolving obesity, it continues and those who gain or remain above desired weight feel it when calories come into the discussion about weight loss and maintenance; yet even with hurt feelings, calories remain in the proper scope of discussion for weight management.

If you look back at Forget the Cake, Let Them Eat Steak, I specifically included a rough estimate of just how few calories Jimmy Moore required to gain the six pounds he did earlier this year before starting his nutritional ketosis experiment - the equivalent of 1.5 tablespoon of butter. If you're a low-carber, you know that's something easy to miss day-to-day!

But truth be told, I'm not even convinced Jimmy's weight gains are simply too many calories!

Remember, I hold that calories in, calories out (CICO) matter in context.  

And I do think Jimmy's experience is a necessary exercise in discovering why he's gained weight while maintaining a carbohydrate restricted diet.  Often the examples we see with weight gain are clear - they've increased carbohydrate back to levels that again disrupt the endocrine system and create a milieu for fat storage and weight gain.  

That is not Jimmy's experience now or in the past - each of his gains and losses have been within the context of a controlled-carb diet. 

When Jimmy posted his latest update, he linked to my post and said "Was it the keto-adaptation or the calorie-cutting that has worked in producing the weight loss success I’ve seen? If you ask me, I say WHO CARES?!"

Well, I care - not only about Jimmy as a person and friend, but also for those within the low-carb community, who despite doing everything seemingly right, fail to lose weight or gain and will do anything - even something extreme - to lose the weight.

So then, what has been going on?  

What context might explain Jimmy's weight gains and losses? 

And more importantly, why are those important considerations for anyone ready to jump on board the nutritional ketosis bandwagon and do what Jimmy's doing?

If nothing else, Jimmy is a prolific blogger - he's got websites, podcasts, YouTube videos, a forum, twitter and facebook - and this leaves us with a lot of information to ponder about his weight maintenance, gains and losses.

Going back and looking at each period where Jimmy gained enough weight to motivate a weight loss attempt, we can see - clearly - he was in a calorie deficit.  And while it would be infinitely easier to simply chalk his gains and losses up to calories, I think, after reading back on dozens of his posts, it was more than that; and something I almost missed in my haste to write this post.

I've written a lot about how low-carb diets often work so well because they resolve underlying metabolic perturbations; endocrine issues like high insulin or hyperglycemia; they set-the-stage, so to speak, to enable to calorie restriction (often spontaneously) necessary for weight loss in a more 'righted' endocrine environment.

Since it is the endocrine system which largely controls our weight and hunger, it needs to function well for weight loss and maintenance. Yet, there are some endocrine issues which a diet alone cannot resolve - they are genetic - and Jimmy has, we've learned through his posts, hypogonadism.

Simply understood, that's where you, if male, have low testosterone, elevated LH and/or FSH, and often it leads to high serum ferritin (iron).  

Jimmy has shared with readers that he has this condition - and it's something, that after reading up on it last night, one cannot change with diet alone. Now this isn't an excuse - but a reason that helps explain why Jimmy's appetite is such that he's driven to eat more than he requires.  Those with hypogonadism are often insulin resistant, suffer abdominal obesity and gain weight easily.

It doesn't take long to look back at Jimmy's eating habits to realize he has a big appetite and eats a lot.  This isn't because he's lazy or a glutton, it's from within him, genetic, from his endocrine system working out of balance.

In the right context, calories come into play as a reasonable explanation of weight loss and gain, and before starting his nutritional ketosis experiment, Jimmy started on hormone replacement therapy - an estrogen agonist and testosterone cream is addressing the issues in his endocrine system that his diet does not address. 

He also added Glycosolve, a berberine supplement that helps with glycemic control.

He started routine blood donations to address his iron levels.

And he's recently re-introduced an exercise regime to build muscle, so yes, he's increased his level of activity too.

Jimmy has not simply changed his diet - he's changed the context of his endocrine system AND his diet.  

Whether or not he wants to recognize it or not, the diet part has led to the necessary reduction in calories which is explaining his weight loss; but the other changes are important factors, ones that I do think will make his weight management long-term easier this time.

He doesn't have a broken metabolism - but he has had unaddressed endocrine issues; those now being addressed should help him long-term because, as I've said, context with calories matters.

In an upcoming post I'll look at nutritional ketosis and hope to explain benefits, risks and whether one should consider it long-term or not.