NBA players offer an interesting insight into the limitations of CICO. They are all millionaires with full time nutritionists/cooks counting their every calorie and macro, yet some of them still struggle with weight gain. Most famously and recently, Luka was porportedly traded by a fitness-obsessed GM for being 30 pounds overweight. The Luka trade has been discussed as one of the worst in sports history, and fat phobia could be an explanation.
Luka's implied daily calorie surplus was around 500 for 7 months out of a daily EE of 4000-5000 calories. That gives us another NBA thought experiment. What's more likely: a millionaire's full time nutritionist can't count to 3500, a hyper competitive player with a single minded lust for dominance can't cut 500 from 4000, or his physiology was causing weight gain regardless of his EI?
Luka has lost weight this summer, either with the help of glp1as or because he's trying a new diet now that he's in LA. His new teammate, LeBron, lost weight a decade ago with Paleo. Perhaps Luka has restricted his carbs now that he's around LA diet culture instead of Texas diet culture.
The thing that keeps the CICO theory alive, is that you can lose weight by starving to death, and you die even faster if you exercise. Everyone knows that. So CICO explains what happens in the total absence of food -- you lose weight and die, but is useless to explain gaining weight when food is consumed. (It's interesting to read cases of people who almost starved to death, but didn't. And were never able to gain weight again the rest of their lives. How did their body adapt to survive on almost nothing? Why are they unable to gain weigh? For example: Adrift by Steve Callahan.)
I seem to recall an animal study where genetically obese mice died of starvation, but still obese. (Was this mentioned in GT’s Why We Get Fat? Or Fung’s Diabetes Code?) The implication being that whatever physiological / hormonal environment was coded by the obesity gene prevented fat utilization and weight loss, even in the complete absence of food (Ein = 0).
I don’t know whether we have analogous human studies, but it aligns with my experience in healthcare settings, witnessing overweight or obese who have “starved themselves” on severe calorie restricted diets and still been unable to lose weight.
So, yes, the genetically lean can and do lose weight by eating less — even to the point of starvation and emaciation — but the genetically obese do not. If the CICO model only works sometimes, it can’t be the right model.
Hey Suzie - yes, I've actually written to Gary about the issue you're talking about (which he wrote about in some of his books, if I recall correctly) - the mice who became obese even while practically starving. A mutual acquaintance of ours (mine and Gary's) did a very nice piece on it here: https://farmerversusbanker.substack.com/p/the-rats-who-starved-to-death-while
I agree that getting fat or not getting fat is related to hormones, and from a clinical perspective we need to ask the question what are the endocrine “influencers” involved.
Eating more to get taller vs. eating more because of increased energy demand vs. eating more to replenish fat stores. Or, for that matter, eating more because you are pregnant. What are the hormones involved? And what signals are involved?
I’m not a researcher, but I would think these things are all measurable.
What I have learned from exercise physiology is that when I exercise at a low level, 99% of skeletal muscle energy production is (supposed to be) from fat. As I exercise more intensely, more glucose is needed until about 65% of capacity, then it is about 50% each, fat and glucose. As exercise intensity continues to increase, like in a fight or flight situation, glucose is then, and only then, the dominant fuel source.
Unfortunately, conventional thinking tells us that glucose is always the preferred fuel source—for the brain and nervous system, yes, but for skeletal muscle, no. So, excess glucose is transformed to fat, and high insulin signals the skeletal muscles to burn glucose, not fat, and we get fat at unhealthy levels.
In addition, if the high carb diet includes excessive fructose, the satiety signal is blocked, so we overeat carbohydrates all the more.
Eventually, the overconsumption of carbs causes Insulin synthesis dysfunction and/or dysfunctional lipogenesis, resulting in diabetes. If these states of dysfunction trigger the sympathetic nervous system, insulin production is further decreased and glucagon is increased and the liver is signaled to release glucose into the bloodstream, making the situation a complete disaster.
Body builders are yoyo dieters in reverse. Our son-in-law routinely loses 40 pounds for competitions and rapidly regains that lost weight afterward. Is he damaging his health? Here is what researchers have learned. https://examine.com/faq/are-bodybuilding-diets-healthy/
One concept I’ve heard tossed around in the discussion of CICO vs CIM is that the law of energy conservation — foundational to the CICO model — only works in a closed system, and since the human body is an open system, the law (and thus, CICO) doesn’t apply in the same way.
But I’ve also heard physicists claim that the laws of thermodynamics work “well enough” in open systems that this need not be an issue.
I don’t recall hearing you speak to this (please direct me to the right text if I’ve just forgotten). Given your background in physics, I suspect you have an opinion! (as the daughter of an opinionated physicist I’m familiar with the archetype)
I'm assuming that there are "hormonal treatments" that are known, sure-fire, 100% to make people skinny? It's just that they are dangerous and cause side effects? So, for example, something that blocks insulin? or makes you grow? or revs up your thyroid? So wouldn't that mean that hormones also make you fat?
NBA players offer an interesting insight into the limitations of CICO. They are all millionaires with full time nutritionists/cooks counting their every calorie and macro, yet some of them still struggle with weight gain. Most famously and recently, Luka was porportedly traded by a fitness-obsessed GM for being 30 pounds overweight. The Luka trade has been discussed as one of the worst in sports history, and fat phobia could be an explanation.
Luka's implied daily calorie surplus was around 500 for 7 months out of a daily EE of 4000-5000 calories. That gives us another NBA thought experiment. What's more likely: a millionaire's full time nutritionist can't count to 3500, a hyper competitive player with a single minded lust for dominance can't cut 500 from 4000, or his physiology was causing weight gain regardless of his EI?
Luka has lost weight this summer, either with the help of glp1as or because he's trying a new diet now that he's in LA. His new teammate, LeBron, lost weight a decade ago with Paleo. Perhaps Luka has restricted his carbs now that he's around LA diet culture instead of Texas diet culture.
Great comment 👍
The thing that keeps the CICO theory alive, is that you can lose weight by starving to death, and you die even faster if you exercise. Everyone knows that. So CICO explains what happens in the total absence of food -- you lose weight and die, but is useless to explain gaining weight when food is consumed. (It's interesting to read cases of people who almost starved to death, but didn't. And were never able to gain weight again the rest of their lives. How did their body adapt to survive on almost nothing? Why are they unable to gain weigh? For example: Adrift by Steve Callahan.)
I seem to recall an animal study where genetically obese mice died of starvation, but still obese. (Was this mentioned in GT’s Why We Get Fat? Or Fung’s Diabetes Code?) The implication being that whatever physiological / hormonal environment was coded by the obesity gene prevented fat utilization and weight loss, even in the complete absence of food (Ein = 0).
I don’t know whether we have analogous human studies, but it aligns with my experience in healthcare settings, witnessing overweight or obese who have “starved themselves” on severe calorie restricted diets and still been unable to lose weight.
So, yes, the genetically lean can and do lose weight by eating less — even to the point of starvation and emaciation — but the genetically obese do not. If the CICO model only works sometimes, it can’t be the right model.
Hey Suzie - yes, I've actually written to Gary about the issue you're talking about (which he wrote about in some of his books, if I recall correctly) - the mice who became obese even while practically starving. A mutual acquaintance of ours (mine and Gary's) did a very nice piece on it here: https://farmerversusbanker.substack.com/p/the-rats-who-starved-to-death-while
Thanks Amy — I’ll check it out.
Also, as someone with a background in the history of science, I just want to say what a sick burn it is to compare CICO to phlogiston.
I agree that getting fat or not getting fat is related to hormones, and from a clinical perspective we need to ask the question what are the endocrine “influencers” involved.
Eating more to get taller vs. eating more because of increased energy demand vs. eating more to replenish fat stores. Or, for that matter, eating more because you are pregnant. What are the hormones involved? And what signals are involved?
I’m not a researcher, but I would think these things are all measurable.
What I have learned from exercise physiology is that when I exercise at a low level, 99% of skeletal muscle energy production is (supposed to be) from fat. As I exercise more intensely, more glucose is needed until about 65% of capacity, then it is about 50% each, fat and glucose. As exercise intensity continues to increase, like in a fight or flight situation, glucose is then, and only then, the dominant fuel source.
Unfortunately, conventional thinking tells us that glucose is always the preferred fuel source—for the brain and nervous system, yes, but for skeletal muscle, no. So, excess glucose is transformed to fat, and high insulin signals the skeletal muscles to burn glucose, not fat, and we get fat at unhealthy levels.
In addition, if the high carb diet includes excessive fructose, the satiety signal is blocked, so we overeat carbohydrates all the more.
Eventually, the overconsumption of carbs causes Insulin synthesis dysfunction and/or dysfunctional lipogenesis, resulting in diabetes. If these states of dysfunction trigger the sympathetic nervous system, insulin production is further decreased and glucagon is increased and the liver is signaled to release glucose into the bloodstream, making the situation a complete disaster.
Body builders are yoyo dieters in reverse. Our son-in-law routinely loses 40 pounds for competitions and rapidly regains that lost weight afterward. Is he damaging his health? Here is what researchers have learned. https://examine.com/faq/are-bodybuilding-diets-healthy/
Another consideration is unabsorbed calories. https://www.bmj.com/rapid-response/2011/10/31/unabsorbed-calories-important-consideration
Typo: "In those case, wasn’t it reasonable to assume that these people were obese because of their insatiable appetites?"
One concept I’ve heard tossed around in the discussion of CICO vs CIM is that the law of energy conservation — foundational to the CICO model — only works in a closed system, and since the human body is an open system, the law (and thus, CICO) doesn’t apply in the same way.
But I’ve also heard physicists claim that the laws of thermodynamics work “well enough” in open systems that this need not be an issue.
I don’t recall hearing you speak to this (please direct me to the right text if I’ve just forgotten). Given your background in physics, I suspect you have an opinion! (as the daughter of an opinionated physicist I’m familiar with the archetype)
I'm assuming that there are "hormonal treatments" that are known, sure-fire, 100% to make people skinny? It's just that they are dangerous and cause side effects? So, for example, something that blocks insulin? or makes you grow? or revs up your thyroid? So wouldn't that mean that hormones also make you fat?
Thank you!!! I think I finally understand this now. Your analogies were spot on.