Caloric Deficit Myth? Answer me this...

[DirtyWilly]

I'm gonna throw an unpopular opinion out there because I see the same responses over and over, but I'm not sold on caloric deficits being the primary driver of weight loss. It just doesn't add up in the real world...

I get it, calories in, calories out, can't defy physics, but answer me this. How can patients that undergo bariatric surgeries that bypass or remove most of the stomach still gain weight? Most of these people are physically incapable of absorbing more than 800 calories in a day yet they stall, regain weight and some regain all of it back. How is that possible?

I've seen excuses such as poor food choices, the stomach re-stretched, I don't even think the doctors know. After the "honeymoon" period the success rate is only 50%. How? There's countless stories of patients that follow their 800 calorie diets to the letter and regained it all. Then you have people with genetic conditions that are 10% bodyfat in the upper body, and 90% bodyfat in the lower body. How does a female gain weight in the breasts when men don't? I guarantee they weren't eating more than men. Did just their breasts eat more?

Something is missing from this formula. Is it hormones? Are caloric deficits only activating weight loss hormones to a certain extent? Maybe we should be looking at hormones and proper signalling more than calories? Anyways, curious to see responses.

 

[TheMrMuscle]

One of the possible reasons for weight gain after surgery can be the patients microbiome. The state of our Gut Bacteria seems to have a great impact on how much energy we derive from our food.

https://www.ncbi.nlm.nih.gov/pubmed/23571517

 

[Jm88888]

I think to chime in on the actual question: the only way to lose “weight” is calories deficit. But if you want to lose fat, you’d better be very mindful of insulin, eat over the amount of protein that you need, and make sure your dietary fat is at least dialed in to allow for basic bodily and hormonal functions.

 

[u_e_s_i]

TheMrMuscle's right that gut bacteria can play a large role in whether or not a person put on weight. I've read about identical twins with different microbiomes who end up acquiring very different body compositions, say one becomes obese whilst the other is of a normal weight.
How the person's body responds to only consuming 800 calories on a regular basis and food choices will also play a part. If a person who's maintenance is 2800 calories a day consumes just 800 calories daily for months on end their body might go into 'actual starvation mode' and readjust their metabolism so that they start gaining weight again. I've read that this happens to people who diet too hard for too long. Eating 'unhelpful' foods will exacerbate the situation.
Meal timing will play a part too, as if a subject with low hgh that day (read on for why), eats nothing all day 1 whilst doing very little and consumes all 800 calories in the form of ice cream, cookies and donuts right before bed (maybe they know nothing about meal timing) (also if they did this, it's likely they'll overeat or underestimate what they've eaten) and this becomes habitual, there'll be a vicious cycle.

All of the above are testament to the idea that there are other, potentially significant, factors which factor into whether or not a person loses or gains weight on y calories. The calories in vs calories out equation is a simplification of the reality and is only a good approximation for people without particularly favourable or detrimental genes

OP I'm not sure what you mean in the latter half of your third paragraph

 

[Sbell71]

OP, seems you answered some of your own questions. But In regards to “countless stories of regaining weight on 800 calories” calorie absorption post sleeve or Roux-en-Y surgery it is physiologically and/or hormonally reduced drastically. If they remain on that diet even with a 30%-50% reduction in metabolic rate weight gain is not possible. Obvious exceptions given with caloric needs of a 5 foot woman vs a 6 foot man, age, etc. being 800 calories isn’t a one size fits all. Insulin resistance, type of dietary restrictions, metabolic disorder and others all contribute to the formula/answer you are looking for.

 

[john.patterson]

I think hormones and genetics definitely play a large role in body fat set point and one's ability to lose weight. Calories in/calories out is a simplification of many factors, but this idea is relative to each individuals TDEE. Everyone has a different calorie maintenance which determines how many calories the need to function on a daily basis. It isn't always this simple, but for most people without thyroid problems or metabolism conditions the "cals in/cals out" approach works.

I also think another factor in successful weight loss is simply that people don't know how to accurately count calories. Some of my clients swear they're sticking to their nutrition plans, and it turns out they're consistently eating 500-600 calories more than what they thought each day.

 

[HIT4ME]

A calorie is merely a measure of heat (energy).

Mass and energy can neither be created nor destroyed.

Mass and energy are the same thing.

If you gain weight, you had to ingest the equivalent amount if mass.

There is no way around this. You cannot gain a pound without ingesting a pound of food.

Not sure why you think someone with a gastric bypass can only absorb 800 calories? Can someone without only absorb 1600 or 2400 calories?

 

[muscleupcrohn]

A calorie is merely a measure of heat (energy).

Mass and energy can neither be created nor destroyed.

Mass and energy are the same thing.

If you gain weight, you had to ingest the equivalent amount if mass.

There is no way around this. You cannot gain a pound without ingesting a pound of food.

Not sure why you think someone with a gastric bypass can only absorb 800 calories? Can someone without only absorb 1600 or 2400 calories?

And even if you eat a pound, the only time you’ll actually weigh a full pound more is when it’s still sitting in your stomach. Obviously not 100% of what we eat is stored as muscle or fat, or we’d all weigh at least several tons. The energy from what we eat gets used for a lot of other things/processes that prevent it from being stored (and increasing body weight).

 

[HIT4ME]

And even if you eat a pound, the only time you’ll actually weigh a full pound more is when it’s still sitting in your stomach. Obviously not 100% of what we eat is stored as muscle or fat, or we’d all weigh at least several tons. The energy from what we eat gets used for a lot of other things/processes that prevent it from being stored (and increasing body weight).
View attachment 160097

Yes, yes, true, true.

But I was reading a diet book that blames my glandular condition and told me it isn't my fault. So I am gonna believe that over thermodynamic theories that people only believe because of thousands of experiments and their ability to predict outcomes in reality.

 

[muscleupcrohn]

Yes, yes, true, true.

But I was reading a diet book that blames my glandular condition and told me it isn't my fault. So I am gonna believe that over thermodynamic theories that people only believe because of thousands of experiments and their ability to predict outcomes in reality.

 

[DirtyWilly]

Not sure why you think someone with a gastric bypass can only absorb 800 calories? Can someone without only absorb 1600 or 2400 calories?

If you sat Kobayashi (hot dog eating champion) in front of a plate of unlimited hot dogs, how many could he eat before he physically couldn't stuff another one in? How many of those hot dogs could he absorb as calories in a day? If you did that to a gastric bypass/sleeve patient you'd not only physically not be able to force as much down, you'd have absorption problems. In the early periods after the surgery, most can't keep more than 800 calories, from a typical diet, a day a down before they get extreme pain or get sick.

But this is hitting on my point exactly. Why are the calories the driving force behind weight loss when they're not a measurement of weight? It would be like an electric car gaining weight from consuming too many watts.

 

[HIT4ME]

If you sat Kobayashi (hot dog eating champion) in front of a plate of unlimited hot dogs, how many could he eat before he physically couldn't stuff another one in? How many of those hot dogs could he absorb as calories in a day? If you did that to a gastric bypass/sleeve patient you'd not only physically not be able to force as much down, you'd have absorption problems. In the early periods after the surgery, most can't keep more than 800 calories, from a typical diet, a day a down before they get extreme pain or get sick.

But this is hitting on my point exactly. Why are the calories the driving force behind weight loss when they're not a measurement of weight? It would be like an electric car gaining weight from consuming too many watts.

Calories are a measure of energy. Energy and Mass are interchangeable. They are, indirectly, a measure of weight. More importantly, they are a measure of the weight that you can convert. For instance, water has no usable energy, so it has no calories. It still has mass, but our body can't store it for energy. You can get heavier off of water, but you will never get fatter from water. Many fibers doesn't get absorbed so they don't have any conversion into becoming actual tissue in our body.

Do you have any data suggesting that most gastric bypass surgery patients can't keep down more than 800 calories a day? This is likely a recommendation by doctors after the surgery, but has no bearing on the ability to "absorb" the nutrients. It probably has more to do with your stomach healing over a couple weeks and you need to avoid stretching it so it can heal - so they have a guideline for this. Plus, with a smaller stomach, yes, the stretch will hurt.

Your theory that a bypass patient itself can't "absorb" more than 800 calories, is a theory that actually would inhibit weight gain - not promote it. If you ate 1200 calories and got sick from it, you would lose the mass you just ate through vomiting. If you ate it and didn't get sick but couldn't absorb it, it would pass through your digestive tract like fiber does and eventually come out as waste and you would lose the weight of what you ate that way.

 

[Sbell71]

There are also the hormonal changes that occur as a result of the roux surgery. Insulin resistance is greatly diminished, in some cases reversing Type 2 diabetes immediately. The cascade of benefits related to this hormonal shift alone contributes greatly to slowing and reversing metabolic syndrome. Reduced systemic inflammation, etc

 

[Sbell71]

In regards to post gastric surgery another inhibitor of caloric absorption beyond the greatly diminished physical space that is your stomach and/or intestine is the dumping syndrome that rapidly evacuates the contents consumed which also voids calorie absorption.