The Truth About Overweight & Obesity
Enough pain, shame, frustration, and judgment. You can lose the weight you hate. Here’s the truth.
The “Eat Less, Move More” Or “Calories-In/Calories-Out” Model For Losing And Managing Weight Is A Failure
Dr. Gary V. Koyen, Ph.D. | March 2021
What we've been told
The “Eat Less, Move More” model of weight loss is a “calories-in/calories-out” model. If we’re fat it’s because we’ve consumed too many calories and burned too few. The EL/MM model of calories-in/calories-out assumes all calories are the same. A calorie is a calorie. The problem is that we’re eating too many, and not using up enough.
It is absolutely common sense. Right? If we don’t want to become fat we have to avoid eating excess calories. Right? If we want to lose weight we need to eat fewer calories. Right? What’s the big mystery about this? It’s pretty straightforward. Also, if we want to avoid becoming fat we need to be more active and burn more calories. If we want to lose fat we need to be more active and burn more calories. Simple. If we want to avoid putting weight back on we need to simply continue to eat less and move more. What’s so hard about that?
So, if we fail at this regimen it’s because we eat like pigs and just lay-about? We eat too much and move too little? It’s our fault, due to our weak will, gluttony, and sloth? Then I guess we deserve the judgment we earn from others. After all, who wants to respect a fat, undisciplined person?
The truth is we hate being fat, and we experience frustration, shame, and emotional pain as we repeatedly fail. We judge ourselves and we know we’re being judged by others. Most of us have tried hard repeatedly to take off the weight and keep it off. Why have we failed?
The simple answer is that what we’ve been told is wrong. The model is wrong. In the EL/MM model, efforts to lose weight or manage weight very predictably end in failure. Literally millions upon millions of people have used “Eat Less, Move More,” only to fail. Hear me: The model is wrong. It doesn’t work.
Hey, But What About...?
Wait, what about concentration camps where people are given little food and are worked hard. All of them lose weight. And what about the TV program “The Biggest Loser?” They took morbidly obese people and shed 100s of pounds by eating less and moving more. True. There’s no question that starvation leads to weight loss. The longer the starvation, the more the weight loss, all the way to the point of death. Our bodies can’t live on air alone. We need food. I guess a political concentration camp is the ultimate “Eat Less, Move More” program. No fat people walk out of a labor camp. As for “The Biggest Loser” the joke is that there are no reunion programs. Why would that be? You know the answer: They regain the weight they took off.
But why? Why can’t they just continue with “Eat Less, Move More” and keep the weight off? Actually, there’s a number of answers to this question. Before we go to those answers let’s grant several “truths.”
- It’s true that avoiding overeating is a good thing, and we’re not claiming that it isn’t. Traditional cultures in parts of Japan approach eating with “hara hachi bu,” a discipline of eating until only 80% full. It’s rare to see an overweight person in these cultures. France has a culture of disciplined eating, and has much lower obesity rates than America. In short, overeating as a habit is not wise or helpful.
- It’s true that exercise is a good thing. There are many positive reasons for engaging in exercise and strength-building. We’re not suggesting that people avoid being active. Being active, and engaging in exercises that increase aerobic fitness, strength, and basal metabolism is a very good thing for our health and vitality.
Why "eat less" fails
In the “eat less” model, we are asked to reduce calories to the point that we’re not consuming enough for our bodies’ energy needs. Perhaps—as a 6’ tall man—instead of 2250 calories I consume 1500 per day, well below my projected burn rate. Or maybe even 1200 calories instead of 2250. The idea is that this will cause me to burn stored fat calories. Makes complete sense, but there are problems.
- Lowered Metabolism. Sustained calorie restriction pitches the body into starvation mode. In starvation we are chronically under-nourished. We are not consuming enough calories and therefore we are wasting away. The body begins consuming itself—both fat stores and muscle, and the eventual end state is death. In our evolutionary history, death from starvation was a very real threat. So our bodies evolved to make adjustments to calorie deficits, and avoid death from starvation. One of those adjustments is lowered metabolism: The body automatically lowers its burn rate in order to preserve calories for survival. The greater the calorie restriction, the more the metabolism is lowered. As we reduce calories our bodies burn fewer calories, not more, which works against our efforts to burn more calories through exercise.
- Body Temperature. Due to lower metabolism, and burning fewer calories, our bodies are colder. We feel colder, even with extra clothes or blankets. Our extremities are colder. Our bodies “hunger” for heat. We want more fuel to burn.
- Fatigue. As calorie restriction continues and our metabolism gets slower, we are more mentally and physically tired. It’s harder to burn more calories with our brain and through exercise when we’re fatigued.
- Elevated Ghrelin. Calorie restriction results in elevated hunger hormones, especially ghrelin. Due to elevated ghrelin we begin to feel chronically hungry. The constant feeling of hunger is hard to manage. When our willpower collapses we often eat a large serving of calories. Even worse, ghrelin stays elevated for more than a year after we stop the calorie restricted regimen.
- Reduced Leptin Influence. Leptin is one of the brakes on over-eating and over-storing of fat. It reduces the feeling of hunger and reduces fat storage. When our caloric intake is reduced, leptin tends to get “quieter.”
- Reduced Peptide YY Influence. Peptide YY is one of the more powerful hormones that tell us we’re full—satiated. When we reduce our calories consumed, Peptide YY becomes “quieter.” And worse, Peptide YY tends to stay reduced in influence well after we stop the calorie restriction program.
- Reduced Nutrients. When we reduce calories, odds are near certain that we will reduce the nutrients the body needs for functioning. We may even reduce the amount of essential electrolytes that maintain so many of our bodily systems. When we lower these nutrients we will feel worse, and we will increase the amount of “hunger” we experience.
- Type And Quality Of Calories. All calories are not the same. A calorie is not a calorie. Some calories have very positive effects, and some very negative. Much of the problem of being overweight can be traced to the types of calories we are eating. For most people, reducing calories does not result in improved content and quality of calories. Reducing total calories without addressing the types and quality of our calories is doomed to failure.
- Hormone Imbalances. The really big factor, however, is that overweight and obesity are primarily due to problems with hormones. Over the long run elevated insulin, elevated ghrelin, suppressed Peptide YY, and ineffective leptin are going to drive fat deposition. Calorie restriction does not fix this problem. The only route to long-term weight loss and good body composition is restoring properly functioning hormones.
To sum it up, in the short run we may be able to lose weight through eating less. But when we restrict calories there are many offsets that come into play and interfere with the effectiveness of calorie restriction—especially over the long term. In addition, calorie restriction does not fix the key drivers of overweight and obesity.
Why "move more" fails
The other half of “Eat Less, Move More” is move more. Be more active, exercise more, lift more weights. As we’ve said, being active and exercising are good things. They produce really valuable health benefits. Unfortunately, exercise has little impact on weight loss. A 180# person will burn about 100 calories per mile walked; a 120# person will burn about 65 calories per mile walked. An hour of jogging burns about 400 calories. A single donut is 250-350 calories, so we would need to walk about 3-4 miles to offset the calories in just one donut.
Also, exercise tends to increase appetite, so those who exercise seem to eat more calories. Last, because exercise is strenuous and takes time, we tend to overestimate how much good we’re doing in terms of burning calories. So, many people “give themselves permission” to eat more: ”It feels like I really did something.”
But the really big factor, again, is hormone imbalances. Overweight and obesity are primarily due to problems with hormones. Exercise does not fix this problem. The factor that governs long-term weight loss and good body composition is restoring properly functioning hormones.
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