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Well, I'll die with a jar of Tostitos Queso on the table and can of beer from one of my 2 favorite breweries. Smile on my face.
You can't outrun physics: calories in, calories out. The universe doesn't care about your genetics, doesn't care about your physical or mental health issues - it obeys the law of the land. If you burn more than you consume, you lose weight. If you consume more than you burn, you gain weight.
It is more complex than that. You cannot help people to lose weight by putting them on "cold turkey" - by withholding food from them forcibly. It will just make the patient quit the treatment.
So, to sum it up: Is it "calories in = calories out"? Yes. Is it a cruel way to see things? Also yes.
Does it help patients to effectively lose weight? Surprisingly, no; despite it being a dead simple rule.
What actually does help the people lose weight is to build alternative routines; i.e. those that make the people adapt healthy behavior that displaces unhealthy behavior. Teaching how to eat well does more than teaching to not eat high-calory food. Teaching how to prepare a salad that actually tastes well does more than withholding chocolate.
It's a bit more nuanced than that
it's really not, you can make it more nuanced but it's really as simple as eating different and less.
I have personally lost 40lbs by eating different. no physical activity changes, only food. I stopped eating carbs and sugar. i essentially went keto and within 5 mo ths, 40 lbs vanished. I went from. a 41 pant to a 34/36 and shirts went from XL to M/L.
Specifying carbs and sugar is already bringing more nuance than just "calories in, calories out".
There was another comment I replied to earlier that summed it up pretty well, so I'm just going to paste it here.
Of course it's that simple. It always was. Purely technically speaking. Reduce calories in whatever way and probably even exercise to some degree. No magic needed.
It's just not that easy for everybody equally. Some just can't regulate themselves well, some take drugs that fuck your weight up even if you'd just eat a slice of bread daily, some can't exercise at all, some are too poor to buy non-shitty foods (especially in horrible food-anarchy-countries like the US where sugar is legion), and some simply don't know better or don't understand.
You saying "is it really that easy?" Is survivorship-bias. You succeeded where millions(?) fail. But congrats anyway 😁
I never said easy, I said it's simple. simple things can still be difficult to achieve and maintaining it is even more difficult, but it's still a simple thing of eating less, and not eating carbs // sugar to get energy.
The top definition of simple is as an adjective and it's:
easily understood or done; presenting no difficulty
While you likely meant it in the exclamation form:
used to convey that something is very straightforward
Straightforward would probably be a better synonym of simple to use in this instance.
some take drugs that fuck your weight up even if you’d just eat a slice of bread daily
Drugs can't violate the laws of physics. If you eat nothing but a slice of bread daily and you're overweight, you can't not lose weight.
What a drug can do it is influence your brain/cravings/etc. so that you're more/less likely to eat X amount, and that in turn makes you gain/lose weight.
The opposite is also true, such as in the case of GLP-1 inhibitors. But these drugs come with unwanted side effects, and there seems to be a rebound once one stops taking the drug. This discussion already is highly nuanced! So perhaps it's not as simple as counting calories, after all.
Of course, you're right, I edited my comment to reflect that.
Ultimately my point is, drugs can 'influence' you into eating more/less, but they definitely can't prevent you from losing weight while starving yourself.
Generally speaking though, it's very difficult to starve yourself since your body wants to maintain homeostasis. I don't think that's a good way to lose weight, even if it's for the sake of better health.
The big secret is hormones, don't interfere with your hormones and the body will self regulate body composition to optimal (lose weight if your obese).
[Paper] The Carbohydrate-Insulin Model of Obesity - Beyond “Calories In, Calories Out” - 2018
TLDR - Eating sugar and carbohydrates forces blood glucose levels to rise (within minutes), elevated blood glucose forces insulin to rise (to reduce blood glucose), elevated insulin forces the body to go into anabolic (gain weight) state. Basically you can't lose any fat while your insulin is high, so every time someone eats a bunch of sugar or carbohydrates with a meal/snack they are putting a 2-4 hour pause on any fat loss.
Also the laws of thermodynamics your using in your It's simple CICO statement require a closed system without mass transfers. Humans are open systems, eating, pooping, breathing, peeing, drinking... All the time. So yes CICO is technically correct, it's not clinically helpful to most people.
This video explains a fair bit of the nuance.
This article explains more.
Are you a bomb calorimeter? A calorie is a unit of heat energy, how are you eating it? From the article itself:
"For decades we've been telling Americans that you're lazy, it's your fault, you're not moving enough, you're eating too much," Mozaffarian says. "And I think what this study shows is that there's really complicated biology happening and that our food is driving this."
It's not simple, nor is it straightforward. Our bodies are complex.
this post was submitted on 24 Jul 2025
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