I'll bet if you read this book, you'll take a long, hard look at your current dietary practices.

At the least, it has been the most science-backed explanation of the horrendous obesity epidemic that has ravaged the world since 1977,

And by the way, he does admit it's all about calories in - calories out.

You don't really need science to explain this, though. Just sociological observations. Increases in processed, high calorie foods combined with a reduction in physical activity results in more fat people.

2. His 'calories in / calories out' agreement is a gross mischaracterization of his concepts. If if were as simple and easy as calories in/calories out, our current dietary recommendations would have completely solved diabetes. In his book, he presents a smorgasboard of studies, many of which are high-profile large-scale studies that show that this simplistic view of calories in/out, while it might work in the short-run, UTTERLY fails for long-term weight maintenance. (He goes into detail of the saga of Dr. atkins and the research done around it including NEJM articles, and how it all crashed down once people tried to hang on to their weight loss for more than a year or two.) Fung's approach is for LONG term weight loss, based upon hormonal control of fat and weight - an utterly different approach to calories in/out, even if the net result is less calories in and more calories out.

You want portion control? Start eating broccoli, lots of it.

It's called Thermodynamics.

You want portion control? Start eating broccoli, lots of it. You'll drop weight fast cleaning up a diet.

2. Increasing physical activity as a means of burning more calories only works for short term weight loss and again fails long-term - he provides a few very convincing studies to illustrate this point, including wide-scale measurements of activity that confirm this. Sure, we triathletes are a special cohort that burn so much that we often lose weight when we train, but I'll suspect that the (large) majority of folks here are like me - exercise helps me lose a LITTLE bit of weight, but I get so hungry that the moment I stop exercising, I gain all the weight back and then more weight within several weeks. (He explains the mechanism behind this as well!)

I'm going on the StroBro diet. I'm going to use portion control on pizza and beer.

My comment wasn't addressed at the specifics from an individual level, moreso the societal changes we have undergone in the past 40 years that have resulted in this obesity epidemic. Basically, we're just sedentary, and we have easier access to bad food.

Believe it or not, you likely would gain a bunch of weight in the short-term and then it would STOP.

At one point in my life I was 269 lbs. I was eating like shit, I was doing nothing. At another point in my life I became a slob again, got up to 240 and wasn't doing much. Both times I dropped weight by cleaning up the diet and increasing activity. At 5-9.

I would even state I have a relatively slow metabolism, I'm an easy gainer. Wouldn't really say I was blessed with good genes...but....at the end of the day a diet based on whole foods with better than moderate exercise will see people lose weight. Every damned time.

If you want to learn how to gain weight I know how to do that too.

You're hovering around your setpoint. That's expected.

Wanna try gaining weight to 400? Bet it sounds impossible now.

I know sounds nuts, but that's the type of situation Dr. Fung encounters with his patients with hormonal tumors and other big metabolic derangements. That's the type of knowledge he's working with, and working back to our smaller-scale stuff.

You don't need science to move the needle 5, even 10 pounds over a 4 month period. Eat less, lose some weight, sure.

Now you want to lose weight under that? Under your setpoint? Or stave off that age-related weight creep that gets you over a 20 year period? All of a sudden your easy in-out doesn't work so well does it.

It's called discipline. It's called Mental strength.

No, it's not.

He gives ample examples, including wide-scale studies showing how mental strength has almost no correlation with weight setpoint and effectiveness of the diet outside of very short-term (weeks, MAYBE months) diets.

I'm not going to cite the really good medical studies he shows, but a great example - I'm sure you all know doctors who are obese. These are folks who are amongst the most disciplined, hardest working, most motivated people to accomplish goals they set out to achieve. Yet even they can't do it! Even when they try super hard! (He points out this example in his book.)

It's because the hormones are so powerful. He gives great examples of how he can take low-BMI, highly fit young male athletes, and just by administering IV insulin over a period of time, instantly convert them to obese folks with poor metabolic profiles. It has little to do with motivation and everything to do with the hormones.

Doctors, celebrities, and others have unfortunately made a living by blaming the victims for being weak minded, and then turning around and selling them products to 'fix it.' And we all know how well that's worked out.

It's because the hormones are so powerful. He gives great examples of how he can take low-BMI, highly fit young male athletes, and just by administering IV insulin over a period of time, instantly convert them to obese folks with poor metabolic profiles. It has little to do with motivation and everything to do with the hormones.

Is he being investigated? Because this and the prisoners experiment sound a bit like they've not been through an ethics review to me.

Yeah, and you just showed me that they're not disciplined holistically. Being an obese slob doctor that drinks himself away every night or rolls into Circle K to fill up his ultra gulp is not being disciplined. Were they once? Certainly. But they're definitely mentally weak and they made poor choices.

Give me 6 months, for you specifically. Eat 600g of Broccoli per day. Then fill out the rest of your diet. You'll be loaded with micro-nutrients and you'll feel good.

Calories in, Calories out. Now, what's negotiable is the rate at which you burn calories because every body is different because we have a different code. So you could talk about genetics, I just told you I had a slow metabolism and that I was obese. When I was 269lbs, I was 15, the difference between me then and me now is the fact that I workout like crazy and eat pretty good 75% of the time.

Those doctors you mention don't eat a balanced diet and don't exercise.

At the least, it has been the most science-backed explanation of the horrendous obesity epidemic that has ravaged the world since 1977, and he has some very compelling and convincing arguments and explanations for the underpinnings of this. I'll bet if you read this book, you'll take a long, hard look at your current dietary practices.

"Let me state it as plainly as I can: "Eat Less" does NOT work. That's a fact. ACCEPT IT."


"Many people tell me, "I don't understand, I eat less. Iexercise more. But I can't seem to lose any weight." I understand perfectly - because this advice has been PROVEN TO FAIL." Caloric reduction doesn't cause lasting weight loss. Anybody who has ever tried it can tell you."

Mongo wrote:

However, I didn't see any reference to such publication in your earlier posts in this thread. Can you point me to where I can find that information. I'd love to learn more from what is documented in those independent sources.

Thanks in advance.

It's because the hormones are so powerful. He gives great examples of how he can take low-BMI, highly fit young male athletes, and just by administering IV insulin over a period of time, instantly convert them to obese folks with poor metabolic profiles.

I wonder what would happen if an Inuit Indian adopted a vegan diet....?

His point is that it's actually very hard to gain weight over your metabolic set point, as your body will fight you to pull your weight back down. It works in both directions - losing weight downwards, AS WELL as gaining weight upwards.

At the end of the day, it is calories in and calories out. Study after study after study has shown this for the vast majority of people. Yes, there are examples of people with tumors (IT'S NOT A TOOOMAH). Yes there are examples of people without kidneys, without a pancreas, with diabetes, with three arms, who have unique health problems.

They've done studies where they've varied the make up of the calories (more fat, less fat, all protein, whatever), the timing of the calories (morning, night, lunch), and none of it has mattered. The only thing that mattered was being consistent, and having fewer calories.

Read this.

Calories is an approximation that doesn't account for biological chemistry... Eating same amount of calories of only pure came sugar vs raw broccoli everyday will yield differing results

How big a zip-lock bag does it take to store 600g of Brocolli for just one day? I mean, I eat a lot of brocolli, but that seems like it wouldn't even fit in a one gallon freezer bag.

I follow the research in this realm of medicine, even if i am not an expert, but i am in the field.

What I can say is that the truth is usually in between. Maybe that is not very sexy.

There are some great pieces of research underway regarding health and diet. You can also pick studies to support, or reject, any medical point of view.

Studies of diet and physical activity are exceedingly hard to control. As such, data interpretation is often limited. Take it all wiith a grain of salt. It does not mean it is all wrong, but is also not all right. There is a lot we still do not know. I was chatting with a well known university professor/doctor who does such studies. He described the issues including confounding data, issues with correlation vs causation, patient compliance, study dropouts, and people lost to follow-up. Ignore the fact that 70% of people lie to their doctor (based on studies), often around compliance of such subjects.

The best studies ideally have fully controlled diets, but the people willing to institutanalize themselves long term for a truly controlled diet are limited, and Such studies unintentianally bias for specific socioeconomic status that often does not represent the whole. And when it happens, numbers are small, durations are too short, and dropout skews results. And then there is the correlation and causation issue. With diet it is very hard (impossible) to control only one variable. So take interpretation with a grain of salt.

We also need to distinguish between a population health approach to diet, vs individualized. The answer to one, is often not the answer to another... or at least it is more complex.

National “food guides” were more based on expert opinion (not always facts), and industry always had a hand in the pot. Goals were often widespread with many different interest groups advicating the pros and cons of so many foods. In reality, the biggest improver of life expectancy in the modern world was related to diet... and less people starving to death from malnutrition. And a reduction of birth related deaths... but that is off topic.

Keto diets work (high fat, high protein). I have seen many patients loose weight, get of hypergensive meds, get of lipid lowering meds, get off inulin 100%. I have seen many more get initial gains, but eventually fail because it was not sustainable for THEM.

I have seen many other diets “work” just as well also. A lot of data is there to support the idea that all (reasonable) diets work, and at a population level, humans commitment is what determines sucess, not the specific “diet”.

Day to day, the the focus often turns to small changes that are sustainable to the individual, and which the individual will buy into. This approach is one i promote when people are not willing to buy into wholescale change (and that is most people).

And genetics is part of it. I have been a healthy 130lbs my entire life since i was a teenager. Via bmi i am underweight. I often eat crap. Very often. My family is a similar build. There is no diabetes in my family. There is no overt cancer in my family. No heart disease. One grandfather lived to 94, the other is 102 and alive. My blood pressure is ideal. My heart rate is ideal. My cholesterol is ideal. Maybe i will die of a heart attack anyway. Who knows.

Some people get diabetes early. Some die of heart disease despite a perfect diet/lifestyle. Some people are born with diabetes. I treat diabetes regularily. I have a collegue who came from an area of europe where diabetes was so rare that only specialists deal with it. I would see 2-3 people a day with diabetes, maybe more. He was shocked.

Our current generation is the first generation that is expected to have a shorter life expectancy than their parents.

So the answer is in between. There is science to various diets, and calories in = calories out. And genetics is a part of it. And it is more complex than we like to pretend it is, and we will not all have the same outcomes. We are all different.

This is how I describe health to my patients: life is like poker. In the end we all run out of chips. I can’t give you a winning hand, but maybe we can do things like diet/medication/lifestyle to slip you a few face cards or aces now and then. We should always strive to stack the deck in our favour when it comes to health.

Am doctor who treats obesity and metabolic/hormone disorders. Fung is an idiot. A persuasive one obviously. He does science wrong in that he has a conclusion and then works backwards to support that conclusion. The insulin theory of weight management has been shot down thoroughly in a great series by James Krieger. And done by looking at THE ENTIRETY of literature that is available.

Just because it sounds good to you doesn't make it correct. If you're not familiar with all the literature, I'm not sure how you can be so convinced after reading one book. Dunning-Kruger and such.

https://weightology.net/insulin-an-undeserved-bad-reputation/

This is just a general response to the thread... I’ve struggled with weight my entire life and am by all accounts a successful person in all other aspects of life... for some reason I just can’t get my eating under control. It’s probably the biggest cause of stress in my life. Being overweight does nothing to further any of my goals as an athlete or professionally as someone getting into the coaching business. I’ve tried every diet there is and have come to the conclusion that cutting out a specific food group long term does not work. Sure, I’ve lost a lot of weight on the paleo diet, keto diet, vegan, etc... but eventually it all comes back. I need to read the book someone else mentioned (Hungry Brain, not the original post) as I think that sounds interesting. My experience has taught me that yes it is partially a hormonal issue, but at the end of the day it’s primarily calories in and out. My problem is controlling the calories in portion of the equation and it’s not a matter of willpower. I’m stubborn enough to take 20 hours to finish a bike race, I have will power, but for some reason I’m often helpless when it comes to food... no real point or anything to add in terms of science, just my N=1 experience and venting. If you’re struggling, you’re not alone.

My wife directed me to this book by a legitimate well recognized nephrologist from Canada - I'll bet quite a few of you have read it:

THE OBESITY CODE
By Dr. Jason Fung

Before you all go bashing it as being 'yet another fad diet book' - I can assure you it is NOT. I work in science/healthcare, and I thus absolutely despise all prior diet books, even ones by MDs like the Zone diet, etc. as they are invariably based NOT on peer-reviewed high quality science, but only use science as a thin veneer to give false legitimacy to their unsupported underlying claims.

This one is the first one I've read ever thus far that looks hard and honestly at the obesity epidemic in the world since the 1970s, and how and why pretty much all diets have completely failed to date.

Some of the key concepts that I'm sure most of you die-hard triathlete/dieters will find shocking - some direct quotes:

"Let me state it as plainly as I can: "Eat Less" does NOT work. That's a fact. ACCEPT IT."


"Many people tell me, "I don't understand, I eat less. Iexercise more. But I can't seem to lose any weight." I understand perfectly - because this advice has been PROVEN TO FAIL." Caloric reduction doesn't cause lasting weight loss. Anybody who has ever tried it can tell you."

"Eating is not under our conscious control."

And his 5 erroneous assumptions, listed one by one in chapter 3:
" 1: Calories in and calories out are independent of each other."
"2: Basal metabolic rate is stable"
"3: We exert conscious control over Calories In"
"4: Fat stores are essentially unregulated"
"5: A calorie is a calorie"


I'm not saying it's the be all end all of obesity science, and for sure as science advances there will be refinements and even outright rebuttals to some of his points, but as far as I'm seeing thus far, his explanations and use of science far exceed anything out there. And it's shockingly completely contrary to what you would expect based upon current practices as endorced by the US gov't, and other medical associations.

At the least, it has been the most science-backed explanation of the horrendous obesity epidemic that has ravaged the world since 1977, and he has some very compelling and convincing arguments and explanations for the underpinnings of this. I'll bet if you read this book, you'll take a long, hard look at your current dietary practices.

My wife directed me to this book by a legitimate well recognized nephrologist from Canada - I'll bet quite a few of you have read it:

THE OBESITY CODE
By Dr. Jason Fung

Before you all go bashing it as being 'yet another fad diet book' - I can assure you it is NOT. I work in science/healthcare, and I thus absolutely despise all prior diet books, even ones by MDs like the Zone diet, etc. as they are invariably based NOT on peer-reviewed high quality science, but only use science as a thin veneer to give false legitimacy to their unsupported underlying claims.

This one is the first one I've read ever thus far that looks hard and honestly at the obesity epidemic in the world since the 1970s, and how and why pretty much all diets have completely failed to date.

Some of the key concepts that I'm sure most of you die-hard triathlete/dieters will find shocking - some direct quotes:

"Let me state it as plainly as I can: "Eat Less" does NOT work. That's a fact. ACCEPT IT."


"Many people tell me, "I don't understand, I eat less. Iexercise more. But I can't seem to lose any weight." I understand perfectly - because this advice has been PROVEN TO FAIL." Caloric reduction doesn't cause lasting weight loss. Anybody who has ever tried it can tell you."

"Eating is not under our conscious control."

And his 5 erroneous assumptions, listed one by one in chapter 3:
" 1: Calories in and calories out are independent of each other."
"2: Basal metabolic rate is stable"
"3: We exert conscious control over Calories In"
"4: Fat stores are essentially unregulated"
"5: A calorie is a calorie"


I'm not saying it's the be all end all of obesity science, and for sure as science advances there will be refinements and even outright rebuttals to some of his points, but as far as I'm seeing thus far, his explanations and use of science far exceed anything out there. And it's shockingly completely contrary to what you would expect based upon current practices as endorced by the US gov't, and other medical associations.

At the least, it has been the most science-backed explanation of the horrendous obesity epidemic that has ravaged the world since 1977, and he has some very compelling and convincing arguments and explanations for the underpinnings of this. I'll bet if you read this book, you'll take a long, hard look at your current dietary practices.

Again, sounding like a broken record here, but it's NOT just calories in/out for LONG term weight control.

I haven't read his book and don't plan on reading his book; but if it helps people lose weight then that's great. However, the crux, the core, the primary focus of weight loss and control is calories in and calories out. Yes, food quality matters, food timing matters, a balanced diet matters, but at the very core of weight loss is calories in and calories out. It's worked long term for me - as in DECADES.

Americans are getting fatter because portion sizes have grown tremendously in the past 50 years. Western society has an over abundance of extremely cheap, highly fattening processed foods - a veritable funnel of calories going in at the same time that people exercise less, watch TV or the internet more, and have replaced every form of movement with some sort of assisted power starting with little electronic cars for toddlers. My quack meter goes off when anyone suggests otherwise.

but at the very core of weight loss is calories in and calories out.

Pretty much the whole premise of the book is CICO is flawed, and numerous studies have shown without any doubt that reducing calories rarely leads to long term weight loss, or in the fight against obesity.

I also raised the CICO banner before reading this book, and realized that it's a lot more complicated than I thought. There's a big portion of this book dedicated to this very subject.

Pretty much the whole premise of the book is CICO is flawed, and numerous studies have shown without any doubt that reducing calories rarely leads to long term weight loss, or in the fight against obesity.

I also raised the CICO banner before reading this book, and realized that it's a lot more complicated than I thought. There's a big portion of this book dedicated to this very subject.

lightheir wrote:

Honestly, you guys sound EXACTLY like I did before I read his book.

I strongly suspect you are all only getting tiny snippets of what his whole thought process is of obesity, and judging it incorrectly from that myopic view.

Contrary to the posts above -

1. He is a practicing nephrologist for 20+ years. Very respected, NOT a 'quack' physician which many (?most) of prior diet MDs have been. He regularly and currently treats patients from all walks including ICU patients, using his very same theories - he practices what he preaches, to his patients, and it works. He has successfully weaned possibly thousands of Type 2 diabetics off their medications with his practices.

.

How big a zip-lock bag does it take to store 600g of Brocolli for just one day? I mean, I eat a lot of brocolli, but that seems like it wouldn't even fit in a one gallon freezer bag.

Pretty much the whole premise of the book is CICO is flawed, and numerous studies have shown without any doubt that reducing calories rarely leads to long term weight loss, or in the fight against obesity.

I also raised the CICO banner before reading this book, and realized that it's a lot more complicated than I thought. There's a big portion of this book dedicated to this very subject.

Just curious how you know he is very respected, did it say it on the book, or are you a specialist/physician that works in the Toronto area?

You should definitely read the book that is the subject of this thread. It brings clarity to so many of the points you brought up:

• why have I seemingly always struggled with weight gain
• I don't seem to have control over my cravings or eating (hint: some people actually don't)
• other diets have failed, and weight I lose always comes back, even though I'm a smart person.
  
• probably/maybe a hormonal issue (book definitely says YES, it is)
  
• myth that everyone believes: calories in = calories out. scientific evidence through controlled trials says this is not true, and this belief is partially responsible for the obesity epidemic.
• your ability to control calories in or cravings may in fact be hormonal. how can you get a hold of it permanently?

I'm sure there are shortcomings to this book, or the interpretations of research studies presented (I'm not a doctor). But there are some really good points raised that helped me (and tons of other people) finally "get it".

OP here - this thread turned out EXACTLY the way I thought it would.

I’ll have to think about that... I know I had a double serving of broccoli at a restaurant for lunch that looked like a triple serving and the digestive results weren’t pretty!

I haven't read any books on diet, but I have managed to lose approximately 8 lbs in the last month. No diets, no counting calories. no eliminating anything (although coincidentally I haven't had any alcohol since January), just better food selection.

My view's pretty simple.

People get thin when food is scarce. Human history, with war and famine, shows us that.

When food isn't scare, we need to control our heads and our hands, or get fat.

My view's pretty simple.

People get thin when food is scarce. Human history, with war and famine, shows us that.

When food isn't scare, we need to control our heads and our hands, or get fat.

And that is EXACTLY what a pan-European 10+ year experiment involving circa 20 million people revealed too...

WW2. Putting all the horror, death, murder, genocide, destruction etc to one side, and taking the UK as an example... limited meat, eggs, butter and bread, due to rationing (til the mid 1950s for some produce) but lots of home grown fruit and veg, = the heathiest people by the 1950s and 60s to grace the country. And its been downhill since then as suger and processed foods came easily and cheaply, coupled with an adversion to excercise across the majority of the populus.

I'm still waiting for the OP to explain why I was able to go from 5'9" and a 32BMI to a 22 BMI when I was 23 and have kept it off and at a near constant weight for 19 years by doing nothing except counting calories. According to OP it's unpossible.

It's impossible to do nothing except count calories. You have to select food composition. And food timing. Even if you thought you were just "counting calories" I bet at times you decided to cut down on calories by eating less often (food timing) or by forgoing something that was calorie dense (food composition).

I agree the language in the OP is over-the-top. But I'd bet that if we took all the skinny people in the world, some infinitesimal fraction counts calories. And if we take all the fat people, I bet the vast majority eats shit processed food. I facepalm every time I go to Walmart and see the food choices being made by obese people.

I agree the language in the OP is over-the-top. But I'd bet that if we took all the skinny people in the world, some infinitesimal fraction counts calories. And if we take all the fat people, I bet the vast majority eats shit processed food. I face palm every time I go to Walmart and see the food choices being made by obese people.

That appears to be a contradiction

Counting calories is everything. You could have a diet of pure sugar and loose weight so long as you counted the calories.

Yeah, but alcohol and blueberries tend to have different effects on one's weight. I didn't mean to suggest you were being dishonest, just that its a pretty common phenomenon that when people give up alcohol (even non-intentionally) they tend to lose weight.

I disagree. It's neither a necessary practice to lose weight, it's annoying and cumbersome to do, and plenty of people lose weight without doing it. I don't know why people get so emotionally attached to the notion of "calorie counting."

Not that I said "calorie counting" not that weight loss requires calorie regulation. Calorie counting it just a tool, and not a very effective one.

Diet Coke has no calories, so that would not add to the calories found in the salad dressing right? I realize diet soda is not a healthy choice, but not because of calories.

I disagree. It's neither a necessary practice to lose weight, it's annoying and cumbersome to do, and plenty of people lose weight without doing it. I don't know why people get so emotionally attached to the notion of "calorie counting."

Not that I said "calorie counting" not that weight loss requires calorie regulation. Calorie counting it just a tool, and not a very effective one.

It works like a champ for me every - single - time! It's not difficult at all, just use something like MyFitnessPal. And if you aren't lying about your eating and your exercise then it is 100% effective - at least for me. However, I'm not emotionally attached to it; I only know that it works. If you have something that works for you then by all means use it.

Counting calories might not be 'necessary' but having nfi about calorie consumption and expenditure would be the number one reason people fail at loosing weight

Semantics, but I'd argue a little differently. There's no question that you have to run at a net calorie deficit to lose weight.

But the argument is about what levers of behavior modification are the most effective at achieving that calorie deficit in a sustainable way.

One lever is to spend time every day estimating calorie expenditure and calorie intake and then to make sure that there's an estimated deficit Apparently some people like doing that. But even then I'd argue they're considering food quality and timing as well. Once you regulate calorie intake you're forced to make other decisions. You don't just eat normally and then stop as soon as you reach your daily limit. That'd be dumb to stop eating like at noon. You ration over time. You select foods that are more satisfying rather than drinking a lot of sugar. You don't "just count."

I've found that *just* considering food quality and timing alone is fine for me. I tried "MyFitnessPal" and life is too damned short for logging every damn thing with vague estimates of calories and expenditure. Screw that. The science also suggests that explicit calorie counting isn't that helpful.

But for those it works for, great.

I can tell your the type that likes to needlessly argue.

So, how does someone know if they are in calorie deficit unless they count their calories....yeah Im sure guess work is a much more effective 'lever' than spending two seconds on an app...

It’s pretty easy to know if you are in a calorie deficit if you aren’t counting calories.

I suppose the way to know is to step on the scale every day. Gone up, ate too much...gone down, ate just right.

Not really. Weigh yourself consistently, everyday, on wake up. Usually after the bathroom trip. As long as you control a few simple variables you'll get an idea.

People don't like counting calories because they dontike being slapped in the face with reality.

Yeah, but once a week and you get a bad picture. Weigh yourself everyday and take the average.