The real reason you are not losing weight.

Most people that start exercising or changing their nutrition do so with the ultimate goal of losing weight. 

I’m sure that is not breaking news.

But why is this goal so elusive?

Some people blame genetics. 

Others blame hormones. 

Still others blame their metabolism. 

These might be considerations but the real reason you cannot lose weight is, and keep it off, is so obvious yet so abstract at the same time. 

You’re eating too much. 

Now I know that probably seems like an oversimplification. It’s not. 

I will explain why. And I will give you examples of how this can be true.

If you think that you are eating so little food that you have reached starvation mode, you definitely need to read on and check out (https://www.ebmfitnesssolutions.com/nutrition-blog/starvation-mode-real-or-myth), as I have written about this in more detail. 

If you think your metabolism is broken, faulty or otherwise malfunctioning, you definitely need to read on.  

COUNTING CALORIES DOESN’T WORK

Precision Nutrition has put out some great content on this [8] so I will just give you the truncated version of the idea.

Your weight loss or muscle gain goal is going to come down the not-so-simple idea of calories in versus calories out (CICO).

This, sadly, has become a rather controversial idea with many people pointing to other things like hormones and a dysfunctional metabolism as the reason they cannot lose fat or gain muscle.

Your hormones may be involved in shifting CICO in a way that may not align with your goal but the energy balance equation is still the boss of weight loss or muscle gain.

Most people that struggle to lose weight often state that they are not eating that much and that something else must be wrong.

They are only eating 1000 calories per day and not losing weight. How can this be?

The biggest issue is that people are horrible at truly tracking their calories.

Like, really horrible at it.

Don’t believe me?

There are a bunch of studies [1-6] that all point out the fact that people are horrible at tracking their calories.

In some cases, people can be off by over 1000 calories per day.

And you might think that you are the outlier and your counting is on point. But before you pat yourself on the back, know that even dieticians overeat and under-report. [Gulp]

There was a study [7] done that showed dietitians underreported their food intake by an average of 223 calories per day, while the non-dietitians underreported their intake by an average of 429 calories per day.

Sure, they did a better job, and they should. But even they were off. And this doesn’t even get into the inaccuracies surrounding labels and calorie counts (which I will get into later).

Even just eating 223 more calories per day could lead to a consistent 1-2 pounds per month in weight gain.

COUNTING CALORIES STILL DOESN’T WORK

Accurately tracking the calories you eat can be flawed in other ways than just under-reporting.

The labels you are using to track can be way off.

Did you know, the FDA allows inaccuracies of up to 20% on label calorie counts? And research shows restaurant nutrition information can be off by 100-300 calories per food item [8].

So, even if you do track everything to the letter, your numbers could still be off significantly which can lead to the idea that you are not eating a lot but still cannot lose weight.

Machines, watches, apps and other devices that track how many calories you burn are also not as accurate as you would like them to be.

They provide an output based on averages, and can be off by as much as 20-30 percent in normal, young, healthy people. They may vary even more in older, clinical, or obese populations [8].

There’s no getting around it: If you aren’t losing weight, you either need to decrease “energy in” or increase “energy out.”

While this sounds simple, it is not. Spending time on how and why you are or are not doing things is a step most people skip over.

Trying to white-knuckle more calorie restricting or more exercise is not necessarily going to get you where you want to go.

And even if it did, it would probably be impossible to maintain once you got where you wanted to go.

HOW CAN CICO BE SO OUT OF WHACK?

Your brain is constantly monitoring and controlling CICO. It is sending and receiving messages that involve your gut, hormones, organs, muscles, bones, fat cells, external stimuli (and more), to help balance “energy in” and “energy out.” [8]

To make things even more complicated, there are other confounding factors, such as [8]:

• We don’t absorb all of the calories we consume. And absorption rates vary across food types. (Example: We absorb more calories than estimated from fiber-rich foods, and less calories than estimated from nuts and seeds.)

• We all absorb calories uniquely based on our individual gut bacteria.

• Cooking, blending, or chopping food generally makes more calories available for absorption than may appear on a nutrition label.

Of course, this doesn’t mean CICO doesn’t work. It only means the tools we have to estimate “calories in” and “calories out” are limited.

CICO might sound overly simplistic, but it’s not.

I ALWAYS EAT THE SAME THING

This is a common thing people say when they reach a point of stalled weight loss. They eat the same things and have for some time.

In many cases, their weight is slowly increasing, not decreasing. What sort of sorcery is this?

More than likely, “energy in” or “energy out” did change, but in a way that felt out of control or unnoticeable.

The culprit could be:

• Slight increases in food intake, due to changes in mood, hunger, or stress

• An increase in the amount of energy absorbed—caused by new medication, an unknown medical condition, or a history of chronic dieting

• Physiological changes that resulted in fewer calories burned during exercise and at rest

• The onset of chronic pain, provoking a dramatic decrease in non-exercise activity thermogenesis (NEAT)

• Significant changes to sleep quality and/or quantity, impacting metabolic output and/or food consumed

In all of these cases, CICO is still valid. Energy balance just shifted in subtle ways, due to lifestyle and health status changes, making it hard to recognize [8].

Hormones are also a logical scapegoat for weight changes.

And while they’re probably not to blame as often as people think, hormones are intricately entwined with energy balance.

But even so, they don’t operate independently of energy balance.

In other words, people don’t gain weight because “hormones.”

They gain weight because their hormones are impacting their energy balance. This means it still comes back to CICO.

YOUR PORTION CONTROL IS OUT OF CONTROL

As I highlighted in the beginning, counting calories is horribly flawed and probably not the best way for you to move forward.

In many cases, your portions are so much more than you think which causes you to think, “I’m only eating 1,000 calories a day and I’m still not losing weight!”

A common thought is, “My metabolism is broken.”

But here’s the deal: Metabolic damage isn’t really a thing. Even though it may seem that way [8].

In reality, you underestimate portions in a big way.

Do you always precisely measure out your servings of peanut butter before you eat? It is very easy to end up with an extra 2-3 servings while only thinking it was one.

And, it is pretty easy to sneak a few extra scoops or licks of PB before you put the cap back on and put it away.

Maybe you snack on some kind of nuts. And maybe you have them readily available so you can grab them instead of something else that is less healthy.

But, a serving of nuts is not a lot. It is a lot less than what you think it is. So, if you are just grabbing some as you go, you could easily eat 4-5 servings which adds hundreds of calories you aren’t accounting for.

Do you have kids? Do you ever finish their food when they are done or take bites of their food? This can easily add hundreds of calories and these calories are probably not tracked.

Sometimes you may avoid tracking or logging a food because you feel guilty that you ate it. And if you don’t track it then those calories don’t count, right?

The take home message is that serving sizes that are listed on labels are a lot smaller than you realize.

This makes it easy to overeat while reporting that you only had the servings listed on the label.

WEEKDAYS VS WEEKENDS

As much as you may hate it, the structure of the work week does tend to keep us on task a little better than the free-for-all the weekends can become.

Many people keep their nutrition in check Monday-most of Friday.

After work on Friday though, the wheels start to come off the wagon.

You could actually be maintaining a caloric deficit up through the end of work on Friday and completely erase it and end up overeating by the end of Sunday.

Sometimes, this isn’t even an accident. Sometimes, people “save” their calories for the weekend.

As you can imagine, this strategy rarely works in the person’s favor.

PROCESSED FOODS EQUAL MORE CALORIES

Another reason counting calories is a maddening process is the idea that we do not absorb 100% of the food we eat.

Some of the calories from the food we eat is spent digesting and absorbing those very calories. It’s like a weird calorie cannibalism.

Proteins can burn up to 30% of the calories during the whole digestion and absorption process. Yeah, protein.

Fats are the next highest and carbs are typically the lowest.

Oh yeah, and how processed your foods are matters too. Damn it!

Emerging research shows our bodies handle ultra-processed items like chips or Twinkies differently than kale or bananas [9].

"So if you have a smoothie you’re going to absorb a significant portion of those calories compared to if you eat that food raw or cooked [9].

So not only are those foods lacking much in the way of nutrients but we absorb more of those calories. So not cool.

THE HALO EFFECT OF FOOD

U.S. sales of organics rose from approximately $1 billion in 1990 to $25 billion in 2009 [10]; meanwhile, roughly one-third of U.S. adults now qualify as obese [11].

What the?!

Are organic foods not better? Well, like most things, it depends. The bigger issue here is the Halo Effect of food.

The Halo Effect of food [12] is a fascinating idea that people will eat more of a food they perceive to be “healthy” and often assume foods labeled as “healthier” alternatives have fewer calories that their regular counterparts.

“The logic of halo effects more generally suggests that consumers might judge products with one positive attribute more favorably on other attributes, even when they are not substantively related; if so, organics might be judged as lower-calorie to the extent that perceivers hold favorable attitudes toward organic production. Because natural foods tend to be seen as inherently good and healthy, “organic” halos seem plausible given the back-to-nature connotations of organic production” [14].

This all sounds a little ridiculous, but it makes sense. People are often looking for that “one thing” they need to do to get back on track. It’s never one thing, by the way.

Switching out your regular chips or cookies for the organic ones will get the lbs coming off fast, right?

No.

There are studies [14-17] that show people place a premium on the organic/healthy marketing of foods.

Your body doesn’t care if the sugar or calories are from organic ingredients or not. Calories are calories.

Organic calories are not less than regular calories. Organic calories, in many cases, are not much better than regular calories.

And, organic does not mean what it used to mean. It has become so watered-down and only vaguely resembles what it used to mean.

This was specifically put to test with Oreos in a study [18].

Subjects were split into two groups. A conventional Oreos (N = 42) or for Oreos “made with organic flour and sugar” (N = 72).

The calories for both types of cookies is exactly the same.

One is made with organic ingredients. The other is not. That is the only difference

Participants’ judgments of calorie content relative to other brands were influenced by the organic claim: even though all participants had just read that one serving of the product contained 160 calories, the organic cookies received lower calorie judgments [18].

The people in the study were asked to read something that clearly stated how many calories the organic cookies had in them.

The organic claim influenced participants’ consumption recommendations: the organic cookies were deemed more appropriate to eat more often than were the

conventional ones [18].

Marketers: 1. Consumers. 0

The people in the study though they could eat more organic cookies even though there was no difference other than some organic ingredients.

People eat more organic foods thinking it is healthier. People erroneously infer that it is lower-calorie and that therefore can be eaten more frequently.

Your results aren’t diet dependent. They’re behavior dependent.

Until next time,

Dr. Tom

References:

[1] Macdiarmid, J., & Blundell, J. (1998). Assessing dietary intake: Who, what and why of under-reporting. Nutrition Research Reviews, 11(2), 231-253. doi:10.1079/NRR19980017

[2] Lichtman SW, Pisarska K, Berman ER, Pestone M, Dowling H, Offenbacher E, Weisel H, Heshka S, Matthews DE, Heymsfield SB. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992 Dec 31;327(27):1893-8. doi: 10.1056/NEJM199212313272701. PMID: 1454084.

[3] Chandon, Pierre & Wansink, Brian. (2021). Obesity and the Consumption Underestimation Bias.

[4] Buhl KM, Gallagher D, Hoy K, Matthews DE, Heymsfield SB. Unexplained disturbance in body weight regulation: diagnostic outcome assessed by doubly labeled water and body composition analyses in obese patients reporting low energy intakes. J Am Diet Assoc. 1995 Dec;95(12):1393-400; quiz 1401-2. doi: 10.1016/S0002-8223(95)00367-3. PMID: 7594141.

[5] Annelies HC Goris, Margriet S Westerterp-Plantenga, Klaas R Westerterp, Undereating and underrecording of habitual food intake in obese men: selective underreporting of fat intake, The American Journal of Clinical Nutrition, Volume 71, Issue 1, January 2000, Pages 130–134, https://doi.org/10.1093/ajcn/71.1.130

[6] Mahabir S, Baer DJ, Giffen C, Subar A, Campbell W, Hartman TJ, Clevidence B, Albanes D, Taylor PR. Calorie intake misreporting by diet record and food frequency questionnaire compared to doubly labeled water among postmenopausal women. Eur J Clin Nutr. 2006 Apr;60(4):561-5. doi: 10.1038/sj.ejcn.1602359. PMID: 16391574.

[7] Champagne CM, Bray GA, Kurtz AA, Monteiro JB, Tucker E, Volaufova J, Delany JP. Energy intake and energy expenditure: a controlled study comparing dietitians and non-dietitians. J Am Diet Assoc. 2002 Oct;102(10):1428-32. doi: 10.1016/s0002-8223(02)90316-0. PMID: 12396160.

[8] https://www.precisionnutrition.com/calories-in-calories-out

[9] https://www.menshealth.com/nutrition/a28493677/what-is-cico-diet/

[10] Organic Trade Association (OTA) (2010). 2010 Organic Industry Survey. Retrieved 28 April 2010.

[11] Flegal, K. M., Carroll, M. D., Ogden, C. L., & Curtin, L. R. (2010). Prevalence and trends in obesity among US Adults, 1999–2008. Journal of the American Medical Association, 303, 235–241.

[12] Thorndike, E. L. (1920). A constant error in psychological ratings. Journal of Applied Psychology, 4, 469–477.

[13] Rozin, P., Spranca, M., Krieger, Z., Neuhaus, R., Surillo,

D., Swerdlin, A., & Wood, K. (2004). Natural preference: Instrumental and ideational/moral motivations, and the contrast between foods and medicines. Appetite, 43, 147–154.

[14] Harris Interactive (2007). Large majorities see organic food as safer, better for the environment and healthier — but also more expensive. The Harris Poll #97. Retrieved 12 May 2009. http://www.harrisinteractive.com/harris_poll/ index.asp?PID=813.

[15] Crawford, C., & Krebs, D. (2008). Foundations of evolutionary psychology. New York: Erlbaum.

[16] Wansink, B., & Chandon, P. (2006b). Meal size, not body size, explains errors in estimating the calorie content of meals. Annals of Internal Medicine, 145, 326–332.

[17] Kahneman, D., & Frederick, S. (2002). Representativeness revisited: Attribute substitution in intuitive judgment. In T. Gilovich, D. Griffin, & D. Kahneman (Eds.), Heuristics and biases: The psychology of intuitive judgment (pp. 49–81). Cambridge: Cambridge University Press.

[18] Schuldt JP, Schwarz N. (2010). The “organic” path to obesity? Organic claims influence calorie judgments and exercise recommendations. Judgment and Decision Making, Vol. 5, No. 3, June 2010, pp. 144–150. http://journal.sjdm.org/10/10509/jdm10509.pdf