For decades, the advice for losing weight has been rather simple “Eat less, move more,” or even “Eat fewer calories than you burn!” However, despite the seeming simplicity of it and the willingness of millions to follow it, it seems that we just can’t get rid of those extra pounds. It could be, as many have put it, that the patients simply have no willpower or discipline to follow said rules -- or could it be that the advice itself is wrong? The fact that this weight-loss prescription has an estimated 99.4% failure rate (99.9% for the morbidly obese) seems to suggest that it is time to reconsider the efficacy of such a paradigm and come up with alternative models.\nThe traditional equation suggests that the fat in our bodies is a result of (calories in) minus (calories out): a simple explanation, but fatally flawed. The first mistake it makes is that it does not distinguish between types of calories, it simply assumes that the only important variable is the number of calories consumed. But do olive oil and sugar have the same metabolic responses from the body? No! While the former is absorbed through the small intestine and transported to the liver, causing neither a rise in insulin nor in blood glucose levels, the latter (sugar) does raise both, provoking a response from the pancreas. It is quite clear that not all calories are created equal.\nThis model also assumes that fat storage is unregulated by hormones. Actually, every vital function and system of the human body is autonomically regulated by hormones: blood glucose by insulin and glucagon, height by human growth hormone (HGH), sexual maturity by estrogen and testosterone, body temperature by thyroxine, and countless others. The gastrointestinal, respiratory, circulatory, hepatic and renal systems (just to provide a few examples) are all tightly regulated by hormones and are certainly not controlled consciously. On the other hand we are led to believe that the growth of fat cells is essentially unregulated, so that the simple act of eating will result in fat growth.\nThis is far from the truth, as nowadays they are still discovering new hormonal pathways in the regulation of fat growth; the most famous of all is leptin, although others play a role in it too, like adiponectin, hormone-sensitive lipase, lipoprotein lipase and adipose triglyceride lipase. This also makes us realize that, given that hormones regulate fat growth, then obesity is a hormonal disorder, not a caloric one. \nThis also connects to the myth that the decision to eat or not, or even to feel hungry is mostly if not entirely conscious. The truth is that we consciously decide to eat in response to hunger signals that are hormonally mediated, in that same fashion we stop eating when the body sends signals of satiety, also hormonally mediated. This explains why we may respond to the same smell of delicious food in a different fashion before and after having a large meal; of course the smell is the same, but the body’s response is not. This is indeed also under automatic control, just as you cannot decide consciously when you need to breathe or pump blood.\nPerhaps the most important mistaken assumption of the calorie-counting model is that it assumes that the caloric intake and expenditure (calories in and calories out respectively) are two completely independent variables, and not linked together. This is said in part because although energy intake is very easy to measure (by the food you eat), energy expenditure is more complicated, being the sum of basal metabolic rate, thermogenic effect of food, non-exercise activity thermogenesis, excess post-exercise energy consumption and exercise. In reality, the problem of fat-storing is one of energy distribution, with too much energy being divested to producing fat instead of heat, muscle or bone production (just to mention some), so many obsess about calorie input when output is far more important; and, worst of all, the truth is we cannot decide the ways in which the body spends that energy\nMany experts however ignore this and choose to focus solely on exercise as the only way energy is spent. They assume the fact that the rest of energy expenditure remains constant and that caloric expenditure is not linked in any way to caloric intake, so their theory is that if you eat less and are spending the same amount of energy (or even more, with the exercise) you have to lose weight. This is false, these two processes (intake and expenditure) are linked, and total energy\/caloric expenditure is not constant. In fact it can go up or down by as much as 50% depending upon the caloric intake (among other factors) to maintain energy balance. So, for example, a 40% reduction in calorie intake is counterbalanced by a 40% reduction in calorie expenditure. In simpler terms: Calories Out does respond to Calories In, and in ways that are out of our conscious control, so if you consume less calories, your body is going to adjust to spend less energy, with the net result being no weight-loss at all.\nThis was demonstrated by one of the most ambitious nutrition studies ever done: the Women’s Health Initiative. This randomized trial evaluated the calorie-reduction, low fat approach for weight-loss in almost 50,000 women. One group of these women was encouraged through intensive counseling to reduce their daily caloric intake by 342 calories and to increase their level of exercise by 10%, the expected result was that they would lose an average of 32 pounds every single year. However, when the final results 7 years after came, to the surprise and disappointment of the health experts, virtually no weight loss had occurred despite good compliance of the subjects, not even a single pound.\nIt is no surprise then that this great rebuke of the caloric-reduction approach was simply ignored, with no effort to adjust that model or to look for better explanations on the part of its defenders; the studies and statistics that have proved time and time again that this effort leads to failure on the vast majority of cases were forgotten and discarded, recurring to the same old strategy of blaming the patients for said failure: “It is them who are not complying, it is them who do not have the willpower to live healthy”. Having said that, this story does not end here, as we have not yet answered the most important question of all regarding this issue, because…if calories do not cause obesity, then what does? This, dear readers, we will examine in detail in another article very soon, to give it the attention it deserves.\n[This article was written based on information found in The Obesity Code and The Diabetes Code, both by Jason Fung].