Calorie Restriction for Weight Loss – Can we simply quit pretending it works?

The ‘gold standard’ for weight loss strategies is fittingly termed “Eat Less, Move More” based on the Calories In, Calories Out idea. Because Body Fat = Calories In − Calories Out, dietary specialists suggest that to lose Body Fat, you need to either lower Calories In (ie. Eat Less) or raise Calories Out (ie. Move More). This advice is everywhere you look. The US government (nutrition.gov) tells you this in no uncertain terms.

The American Heart Association provides essentially identical guidelines. It’s all about calories, and the ‘scientific’ method to lose weight is to either limit the calories you eat, or increase how much you exercise.

Calories In Calories Out is basic and shallow

This seemingly basic calculation is flawed because it focuses on the proximate, not the core reasons, as I’ve explored at length previously, The Obesity Code. In brief, we need to understand the core cause why calorie balance is awry, not merely altering calories intakes.

You can make the connection Alcoholism = Alcohol In — Alcohol Out, therefore you either need to drink less alcohol or metabolize more alcohol (with time). Hey, I’ve just solved alcoholism, people! No, I didn’t. Of course, it is typically the addiction (or sadness, or PTSD etc) that causes you to drink alcohol. Simply telling someone to ‘Drink Less’ without treating the underlying addiction (with meds, counselling, support groups etc.) is possibly the most ineffective advice imaginable.

Or assume that an airplane crashes because the force of gravity is larger than the lifting force. So, the superficial and simplistic way of thinking about it is to ‘make sure that gravity is less than lift’ – wider wings or lower weight. But that’s not usually the problem when planes crash. Instead, the reason why gravity>lift is typically due to pilot error, weather or bad maintenance of equipment, and knowing that leads to the successful adoption of improved pilot training, better weather forecasting or better maintenance of equipment rather than wider wings.

Or consider that getting rich is straightforward Money In — Money Out. To get affluent, you simply either need to generate more money or spend less money. Hey, I’ve just conquered world poverty, people! No, I didn’t. If somebody lives in a crime riddled, corrupt country, they can’t grow rich since the opportunities don’t exist. To address it, people emigrate to nations that allow them to become rich. The advice to just ‘make more money’ is almost as unhelpful as the advise to ‘just eat less.’

If somebody is eating because they are depressed, or they are addicted, or they eat too much ultra-processed foods, or they are emotional eaters, then just how can the advise to ‘eat less’ help? It does not. And numerous research illustrate just how ineffective the traditional, universally repeated Eat Less Move More advice truly is.

Does this advise actually work? Absolutely not. Most people already had that impression from personal experience. And the scientific evidence corroborates their perception. Many long term randomized controlled trials, including the Women’s Health Initiative have tried to establish that calorie restriction diets produce weight loss.

Any classic textbook, such as Joslin’s Diabetes Mellitus 14th edition, which I chose because it happened to be in my library, declares firmly that ‘Reduction of calorie intake is the cornerstone of any therapy for obesity” (page 541). But does it work? Hell to the no.

The author concedes that “Successful treatment of obesity…is rarely achievable in clinical practice (page 541) and that “long term success is infrequent”. Jeez Louise. One of the most authoritative textbooks in the world (Joslin’s is the diabetic clinic at Harvard) explains in no uncertain terms that their medication nearly never works! And they’re right. Maybe reassess this ‘cornerstone’ of therapy that nearly invariably fails?

Cutting Calories Doesn’t Work

An estimated 70% of Americans are either overweight or obese, leading to increased risks of type 2 diabetes, heart disease and cancer. Even a 5% weight loss can have significant health benefits. Given those health hazards, as well as the reality that very few people truly want to be overweight, then we can conclude that most of those people are attempting to follow traditional nutritional recommendations to ‘cut your calories’.

The newest study to highlight the magnitude of this futility was published in 2023 in the Journal of the American Medical Association in an investigation called

“Probability of 5% or greater Weight Loss or BMI reduction to Health Weight Among Adults With Overweight or Obesity”

In this study, researchers looked at a huge database of persons over age 17 from 2009 to 2022 and looked at the primary outcome of 5% weight loss or obtaining a normal weight body mass index (BMI). Over 18.5 million patients were included in this study up to 14 years.

The annual probability of losing at least 5% of weight varies according to your initial weight. For most people, the success rate is roughly 1 in 10.

That’s a 10% success rate, or a 90% failure rate. But the higher your BMI, the better the possibilities. Plus, not everybody is striving to lose weight in any particular year. So a 90% failure rate looks fairly terrible, but not crazy tragically bad, right?

Wrong. The results are terrifyingly terrible. Weight often yo-yo’s – it goes up and it goes down. Just because you shed 5% of body weight last year doesn’t indicate that you’ll keep it off. In truth, most individuals realize that keeping the weight off is much, much tougher than losing it.

So, the better approach to look at the statistics is to see how many people were able to get to a normal BMI. Here the findings start to seem gloomy. The overall rate of success is 1 in 37 or 2.7%. That means, the rate of failure is 97.3%.

Closer examination leads to stunning bad numbers. Even in the best-case situation, that you are overweight (BMI 25–29.9) and just need to drop 1 category to a normal weight, your success percentage is still only 5.3% (failure rate 94.7%). But if you are fat (BMI over 30), then your rate of success plummets to 0.65%! Your failure rate is 99.35%!

But the news gets worse. Because of relapse.

Even if you get to a normal BMI, it does little good if you don’t stay there. Even while only 2.7% of persons succeed in obtaining a normal weight, a whooping 43% were not able to maintain that healthy weight.

Cutting Calories

Here’s what we can say with some confidence.

1. Most people wish to lose weight for health and vanity reasons
2. Virtually all nutritional and medical specialists urge decreasing calories as the “cornerstone” of weight control strategies.
3. Non conforming dietary strategies example. fasting, decreasing carbohydrates are regarded as ‘bullshit non-scientific advice’
4. Cutting calories doesn’t work.
5. Cutting calories has never worked. You know it. I know it. Medical Textbooks know it. Researchers know it. Everybody knows it.

So there are two alternative conclusions:

1. The lowering calories advise is good, but many just won’t follow it.
2. The lowering calories advise is terrible.

The ‘authorities’ want to you believe conclusion #1. They say ‘don’t blame us for incorrect counsel. Blame yourselves for being losers’. But there’s two difficulties with that.

First, if conclusion #1 is right, it obviously makes it #2. If you give counsel that people cannot follow, it is, almost by definition, lousy advice.

Second, remember that 70% of Americans are either overweight or obese and the problem is becoming worse. They got there with the typical dietary advice of decreasing calories. Think about a school – if you have 100 children, and 1 fails an exam, then possibly that is the child’s fault. S/he didn’t study or didn’t care. But what if 70 kids failed that test? Is it more likely that the pupils are all at fault, or is it more likely the teacher’s responsibility – s/he did a terrible job teaching.

Similarly, with 70% of Americans either overweight or obese, is it more likely the failing of millions (approximately 270 million) people individually failing themselves and keeping themselves sick, or it is likely that the nutritional advice supplied is bad? The chances significantly favor the bad nutritional recommendations, rather than this being an epidemic of low willpower.

Current weight loss advice is so terrible, people will try anything, because it’s likely better.

Perhaps that’s why there are so many weight loss items that clearly are scams. The present Eat Less, Move More advise is so startlingly awful that people turn elsewhere for counsel, because practically anything is better than official advice. Look at Sensa, advertised as weight reduction crystals that you sprinkle over food and suddenly make you lose weight. It was so blatantly a hoax, and yet millions of people bought it. As if you couldn’t tell it was a fraud just by looking at a picture of the guy selling it.

But most people anxious to lose weight were probably thinking — it can’t be any worse than trying to follow the calorie restriction plan that has completely failed. And they are right.

Perhaps it’s time to go further than Calories In, Calories Out weight reduction advice and its disastrous effects. We can do better. We deserve better. Maybe it’s time to stop blaming the sufferers (of overweight and obesity) and start blaming the nutritional authorities for their ridiculous ‘Eat Less, Move More’ advise.

People claim things like, “diets only works because of calorie restriction”. But calorie restriction doesn’t actually work. Perhaps trying limiting carbohydrates or intermittent fasting might be a better strategy. That’s the inconvenient reality nutritional authorities don’t want you to know.