# Question on dieting re: "calories out"

**URL:** <https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526>\
**Category:** Factual Questions\
**Created:** [September 28, 2017, 3:28pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526 "2017-09-28T15:28:24Z")\
**Posts on this page:** 20\
**Page:** 2

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**Author:** ![Tim\_R.Mortiss](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/tim_r.mortiss/32/142_2.png) [@Tim\_R.Mortiss](https://boards.straightdope.com/u/Tim_R.Mortiss)\
**Post date:** [September 28, 2017, 9:47pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/21 "2017-09-28T21:47:36Z")

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> [@Saint\_Cad](#):
>
> Yet again, not asking for diet ideas. Let me simplify the question:
> 
> What would have a greater impact on burning calories through keeping the metabolism higher and less hunger:
> 
> A) Pigout - eat - eat - eat - fast - fast - fast
> 
> or
> 
> B) Pigout - eat - fast - eat - fast - eat - fast.
> 
> Please limit yourself to those choices and do not add your own diet plan or exercise plan.

I’ll bite (heh heh). I’ve done a variation of your Plan B, but without the Pigout phase. Just fasting on every other day (and after a few weeks, fasting three days a week). It works pretty well, and is quite tolerable (well, for me it is). The one day of fasting makes it easier for me to get “full” on the day of eating, and the day of eating prevents my body from going into “starvation” mode. I don’t see how anyone could function normally during a three day fast.

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**Author:** ![x-ray\_vision](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/x-ray_vision/32/351_2.png) [@x-ray\_vision](https://boards.straightdope.com/u/x-ray_vision)\
**Post date:** [September 28, 2017, 9:54pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/22 "2017-09-28T21:54:59Z")

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You may find the following informative also, OP. Never mind the hokey website name.

[http://www.lookgreatnaked.com/blog/are-frequent-meals-beneficial-for-body-composition/](http://www.lookgreatnaked.com/blog/are-frequent-meals-beneficial-for-body-composition/)

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**Author:** ![Ornery\_Bob](https://avatars.discourse-cdn.com/v4/letter/o/da6949/32.png) [@Ornery\_Bob](https://boards.straightdope.com/u/Ornery_Bob)\
**Post date:** [September 28, 2017, 10:08pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/23 "2017-09-28T22:08:35Z")

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_ **So in terms of burning calories and overall not-being-hungry and all else being equal, which is the better diet plan.** _

They’re both terrible plans because they needlessly screw up your blood sugar and that will mess with you in lots of ways - none of which are good.

Eat like a diabetic - small amounts throughout the day will satiate and keep your blood sugar steady.

You’re talking about different ways to play with calorie restriction and the absolute best way is to restrict calories as little as possible to get into deficit and to do that for every meal of every day. But that won’t work unless you know for sure how many calories it’s going to take to be in deficit and you won’t know that until you log everything you eat. There’s no easy way out.

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**Author:** ![x-ray\_vision](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/x-ray_vision/32/351_2.png) [@x-ray\_vision](https://boards.straightdope.com/u/x-ray_vision)\
**Post date:** [September 28, 2017, 10:22pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/24 "2017-09-28T22:22:12Z")

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> [@Ornery\_Bob](#):
>
> Eat like a diabetic - small amounts throughout the day will satiate and keep your blood sugar steady.

Evidence suggests otherwise. More from Schoenfeld:

> [@](#):
>
> It’s postulated that there’s a tendency towards hypoglycemia (low blood sugar) during the lengthy post-prandial periods associated with infrequent meals. In an attempt to restore blood sugar, your body signals the hypothalamus that it needs food, especially simple carbohydrates. Hunger pangs ensue and you invariably end up eating more than you otherwise would, often as refined sweets. This sets up the vicious cycle of overeating and uncontrolled insulin secretions – a surefire route to unwanted weight gain.
> 
> However, research doesn’t appear to support these lofty claims either. While a few studies have reported that subjects weren’t as hungry when meals were spaced out over the course of a day (8-11), others have failed to detect differences on indices of appetite and hunger regardless of feeding frequency (12, 13).
> 
> In fact, some studies have found that eating three as opposed to six daily meals actually promotes greater feelings of satiety (6, 14). What’s more, evidence is conflicting for how the number of meals consumed affects hunger-related hormones (13, 15). Taken as a whole, the belief that it’s more satisfying to spread out nutrient intake is at best equivocal and likely related to individual factors.
> 
> Insulin Levels  
> Another claim often cited to support spreading meals throughout the day is that it has an “insulin-friendly” effect. According to the hypothesis, eating a few large meals causes a surge in blood sugar, which in turn leads to a spike in insulin levels. Given its role as a storage hormone, the bigger insulin peaks switch on mechanisms that increase fat deposition. Sounds ominous, but the validity of such claims are at best shaky.
> 
> A number of studies have shown that consuming more frequent meals produces a favorable effect on glucose homeostasis (16-20). This invariably translates into reduced insulin spikes and lower mean insulin concentrations. But the overriding question here is, do these findings matter? From a fat loss standpoint, the answer appears to be not really.
> 
> Munsters et al. (21) found that while frequent meals produced significantly lower peaks and more even glucose and insulin values compared with fewer feedings, there was no difference in fat oxidation between groups. Simply, both eating patterns resulted in the same amount of fat burned.
> 
> This study was noteworthy for its tightly controlled methodology. The researchers employed a crossover design where the same subjects consumed both diets and the exact same types and amounts of food. What’s more, the subjects were lean, healthy adults, thereby more relevant to those who regularly work out.
> 
> The bottom line is that those who focus on the insulinemic effects on fat loss/accumulation in a healthy population have their eye on the wrong prize – the enemy is excess calories, not insulin.

> **[T Nation Content](https://t-nation.com/c/t-nation-content/65)**
>
> Discover a more intelligent approach for getting bigger, stronger, and leaner.

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**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\
**Post date:** [September 28, 2017, 10:27pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/25 "2017-09-28T22:27:12Z")

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> [@Whack-a-Mole](#):
>
> You may find this article helpful: [Intermittent Fasting | Science-Based Medicine](https://sciencebasedmedicine.org/intermittent-fasting/)
> 
> It includes your choices above with links to studies.
> 
> Short answer is there appears to be some benefits to it (particularly for those who are obese) but the data is not clear and more study is called for.

Dr. Hall is a good source of well-documented health information. I don’t see in the linked article any recommendation to “gorge” and then fast. Intermittent fasting is another matter, and her bottom line is “Fasting might help, maybe” along with a note that well-designed human clinical trials are necessary and a warning that a noted quackery promoter (Joe Mercola) promotes fasting, which she finds worrisome.

By the way, it is really helpful to have the advice and support of someone in the household who has been long-term successful with an evidence-based diet approach (in my case, props to Mrs. J.).

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**Author:** ![Chronos](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/chronos/32/134_2.png) [@Chronos](https://boards.straightdope.com/u/Chronos)\
**Post date:** [September 29, 2017, 12:01am UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/26 "2017-09-29T00:01:37Z")

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Metabolism rate isn’t just something that happens, and it’s not something that’s entirely determined by what you are (or aren’t) eating. When we say that a particular diet slows down your metabolism, what we mean is that it makes you feel sluggish and feel less like moving around and exercising. But you can move around anyway, despite how you feel. Quite simply, you can’t remove the exercise portion of the equation.

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**Author:** ![Saint\_Cad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saint_cad/32/18907_2.png) [@Saint\_Cad](https://boards.straightdope.com/u/Saint_Cad)\
**Post date:** [September 29, 2017, 4:58pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/27 "2017-09-29T16:58:14Z")

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I know one of the issues with prediabetes is insulin insensitivity. I wonder if there is a leptin insensitivity at work too, especially when overweight and all that fat is making leptin.

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**Author:** ![Snarky\_Kong](https://avatars.discourse-cdn.com/v4/letter/s/a183cd/32.png) [@Snarky\_Kong](https://boards.straightdope.com/u/Snarky_Kong)\
**Post date:** [September 29, 2017, 5:59pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/28 "2017-09-29T17:59:05Z")

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> [@Wesley\_Clark](#):
>
> Abstinence only education works 100% of the time in the prevention of STDs and out of wedlock pregnancies if people will just clamp down and do it.
> 
> But most people don’t promote abstinence only as the solution to these health problems because they recognize the solution doesn’t work.
> 
> To my knowledge there are few/no studies that have found diet and exercise works for the long term (long term, not short term) management of obesity for more than a tiny percentage of people.
> 
> Short term yes diet and exercise lower bmi and body fat. But long term the results are horrible. Very few people are able to permanently cure their obesity with lifestyle alone.
> 
> Seeing how 1/3 of the human race is overweight, we’d need something more effective.

By analogy, you’re suggesting we need something where people can eat high calories foods and not absorb the calories or to make low calorie foods taste just as good as what they’re imitating? Sounds good, I too hope those things are developed.

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**Author:** ![astro](https://avatars.discourse-cdn.com/v4/letter/a/9dc877/32.png) [@astro](https://boards.straightdope.com/u/astro)\
**Post date:** [September 29, 2017, 6:06pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/29 "2017-09-29T18:06:48Z")

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I’ve lost about 40 lbs in the last 3 months and still have ways to go to my goal. I’ve gained and lost weight all my adult life and my dieting was (and is) basically calorie counting but with a difference this time. In the dozen or so past diets where I have lost significant amounts of weight it was just a raw battle of wills with my appetite and one that, over time I was always bound to lose.

I used to think it was all just a calorie in-out equation until I read Taubes Book ["Why We Get Fat](https://www.amazon.com/Why-We-Get-Fat-About/dp/0307474259)" which was a huge eye opener and informs my current dieting where I try to keep it fairly low carb (and no sugar and simple carbs) and do not use artificial sweeteners because of their[supercharging impact on your gut bacteria.](https://www.scientificamerican.com/article/artificial-sweeteners-may-change-our-gut-bacteria-in-dangerous-ways/)

Do calories count? Absolutely… but some calories count more than others. If you have a tendency toward really liking carbs, and gaining weight you need to clutch way back on your carb intake and substitute fats and protein where possible. The reason is two fold.

One, simple carbs cause huge insulin responses and are preferentially sequestered as fat vs being burned. Secondly …and this is the absolute most important issue … simple carbs cause HUGE hunger spikes to the point they will erode almost any level of dietary self control. Successful dieting over time is centered on one simple issue…\* hunger management\*. This is the galactic axis all the suns and planets of dieting swing around. Hunger is still very present in a low carb diet, but it is much less intense, easier to control and your appetite is much less subject to raging fits.

To do this you have to shop weekly for fresh veggies and meats to do salads and dinners. You cannot get get decent, satisfying low carb meals relying on local fast food restaurants. You have to make your meals yourself and bring them to work. It’s work.

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**Author:** ![Saint\_Cad](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/saint_cad/32/18907_2.png) [@Saint\_Cad](https://boards.straightdope.com/u/Saint_Cad)\
**Post date:** [September 29, 2017, 6:14pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/30 "2017-09-29T18:14:34Z")

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> [@astro](#):
>
> I’ve lost about 40 lbs in the last 3 months and still have ways to go to my goal. I’ve gained and lost weight all my adult life and my dieting was (and is) basically calorie counting but with a difference this time. In the dozen or so past diets where I have lost significant amounts of weight it was just a raw battle of wills with my appetite and one that, over time I was always bound to lose.
> 
> I used to think it was all just a calorie in-out equation until I read Taubes Book ["Why We Get Fat](https://www.amazon.com/Why-We-Get-Fat-About/dp/0307474259)" which was a huge eye opener and informs my current dieting where I try to keep it fairly low carb (and no sugar and simple carbs) and do not use artificial sweeteners because of their[supercharging impact on your gut bacteria.](https://www.scientificamerican.com/article/artificial-sweeteners-may-change-our-gut-bacteria-in-dangerous-ways/)
> 
> Do calories count? Absolutely… but some calories count more than others. If you have a tendency toward really liking carbs, and gaining weight you need to clutch way back on your carb intake and substitute fats and protein where possible. The reason is two fold.
> 
> One, simple carbs cause huge insulin responses and are preferentially sequestered as fat vs being burned. Secondly …and this is the absolute most important issue … simple carbs cause HUGE hunger spikes to the point they will erode almost any level of dietary self control. Successful dieting over time is centered on one simple issue…\* hunger management\*. This is the galactic axis all the suns and planets of dieting swing around. Hunger is still very present in a low carb diet, but it is much less intense, easier to control and your appetite is much less subject to raging fits.
> 
> To do this you have to shop weekly for fresh veggies and meats to do salads and dinners. You cannot get get decent, satisfying low carb meals relying on local fast food restaurants. You have to make your meals yourself and bring them to work. It’s work.

How exactly does this answer the question being asked?

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**Author:** ![astro](https://avatars.discourse-cdn.com/v4/letter/a/9dc877/32.png) [@astro](https://boards.straightdope.com/u/astro)\
**Post date:** [September 29, 2017, 7:11pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/31 "2017-09-29T19:11:44Z")

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Re the specifics about fasting what I have found personally re the main utility of fasting if you choose to do it is that on the positive end it will “reset” (within limits) your appetite so less food is satisfying and this effect lasts only a few days to a week or two but can help if you appetite is out of control to get back on the dieting track by managing hunger.

Intermittent fasting only a day is mostly useless to get maximum hunger reset benefits. it needs to be 3 days. Having said this I do not fast because it is an unpleasant and physically exhausting experience. Some people experience a trance like state but I find it generates a bunch of odd aches and pains and makes useful exercising almost impossible. The benefits of fasting (to me) are not worth the aggravation. Others mileage may vary.

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**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\
**Post date:** [September 29, 2017, 9:08pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/32 "2017-09-29T21:08:21Z")

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I doubt that an experiment in mice proves that artificial sweeteners have a “supercharging impact on your gut bacteria” resulting in obesity.

I consulted expert sources in new wave diet technology last night (perused the covers of supermarket tabloids while in the checkout line). The lates,t courtesy of Women’s World, relates the success of Kelly, who lost 195 pounds with special ingredient shakes _that work just like gastric bypass_!  
Or if you’re leery of shakes that apparently do a complete block on food absorption, you can lose 14 pounds by healing your gut, whatever that means.  
A previous issue of the same tabloid hyped a “thyroid detox soup” as a sure-fire quick weight loss aid.

I love this stuff. No boring advice to eat less\* and exercise more.

\*I still have a vivid memory of a not exactly warm and fuzzy E.R. doc I trained with during a med school rotation. I went in with him to see a markedly obese young woman with a mild hemorrhoidal bleed. After assessing her problem/therapy appropriately, as he was leaving the room he helpfully advised her “You need to eat less.”

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**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\
**Post date:** [September 29, 2017, 9:38pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/33 "2017-09-29T21:38:51Z")

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> [@Snarky\_Kong](#):
>
> By analogy, you’re suggesting we need something where people can eat high calories foods and not absorb the calories or to make low calorie foods taste just as good as what they’re imitating? Sounds good, I too hope those things are developed.

If I were rich and/or influential, I’d conduct a large scale study to see what happens if you treat the weight maintenance phase as a condition of endocrine disruption and correct it with drugs.

The problem is losing weight isn’t ‘hard’. Its hard, but it is doable. Eat less, exercise more, use appetite suppressants, etc. That works for weight loss, but most people gain the weight back. Even though most people say that just sticking with the diet will result in permanent weight loss, virtually no studies show that permanent weight loss is possible via lifestyle changes for more than a tiny minority of people. Seeing how overweight affects 1/3 of humanity (and 2/3 of people in most middle and upper income countries) solutions that work for 5% of people won’t cut it.

If you treat the weight phase as being treated via calorie restriction, but treat the weight maintenance phase as a phase of endocrine disruption, you would probably see better long term weight maintenance.

When people lose weight the body fights back. T3, Leptin, CCK, PYY, Amylin, GLP-1 etc, go down while Ghrelin goes up. The end result is people need more food to feel full, they recover from feeling full faster, metabolism goes down, energy goes, down, etc. and the weight comes back.

Normalizing some (maybe most) of those would probably make weight maintenance easier. I saw a study on weight loss where people lost 10% of their bodyweight, and they underwent a variety of changes. Appetite increased, metabolism decreased, they became more obsessed with food, the brain responded differently to food, etc. Once they gave them supplemental leptin, those symptoms went away and they went back to baseline. Appetite and metabolism became more closely matched again rather than them wanting to run a caloric surplus.

So a true cure for obesity will probably require pharmacology.

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**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\
**Post date:** [September 29, 2017, 10:22pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/34 "2017-09-29T22:22:07Z")

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> [@Wesley Clark](#):
>
> …virtually no studies show that permanent weight loss is possible via lifestyle changes for more than a tiny minority of people.

_“There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that ≈20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity (≈1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2–5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success.”_

[http://ajcn.nutrition.org/content/82/1/222S.long](http://ajcn.nutrition.org/content/82/1/222S.long)

> **[Weight-loss maintenance for 10 years in the National Weight Control Registry...](https://pubmed.ncbi.nlm.nih.gov/24355667/)**
>
> The majority of weight lost by NWCR members is maintained over 10 years. Long-term weight-loss maintenance is possible and requires sustained behavior change.

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<div class="post-metadata">

**Author:** ![astro](https://avatars.discourse-cdn.com/v4/letter/a/9dc877/32.png) [@astro](https://boards.straightdope.com/u/astro)\
**Post date:** [September 29, 2017, 10:49pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/35 "2017-09-29T22:49:27Z")

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> [@Jackmannii](#):
>
> I doubt that an experiment in mice proves that artificial sweeteners have a “supercharging impact on your gut bacteria” resulting in obesity.  
> I consulted expert sources in new wave diet technology last night (perused the covers of supermarket tabloids while in the checkout line). The lates,t courtesy of Women’s World, relates the success of Kelly, who lost 195 pounds with special ingredient shakes _that work just like gastric bypass_!  
> Or if you’re leery of shakes that apparently do a complete block on food absorption, you can lose 14 pounds by healing your gut, whatever that means.  
> A previous issue of the same tabloid hyped a “thyroid detox soup” as a sure-fire quick weight loss aid.
> 
> I love this stuff. No boring advice to eat less\* and exercise more.
> 
> \*I still have a vivid memory of a not exactly warm and fuzzy E.R. doc I trained with during a med school rotation. I went in with him to see a markedly obese young woman with a mild hemorrhoidal bleed. After assessing her problem/therapy appropriately, as he was leaving the room he helpfully advised her “You need to eat less.”

Did you even read the article? It’s a serious study reviewed in Scientific American and the author discusses sweetener impact on human diet as as well.

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<div class="post-metadata">

**Author:** ![x-ray\_vision](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/x-ray_vision/32/351_2.png) [@x-ray\_vision](https://boards.straightdope.com/u/x-ray_vision)\
**Post date:** [September 29, 2017, 10:55pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/36 "2017-09-29T22:55:35Z")

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> [@astro](#):
>
> I used to think it was all just a calorie in-out equation until I read Taubes Book ["Why We Get Fat](https://www.amazon.com/Why-We-Get-Fat-About/dp/0307474259)" which was a huge eye opener

Gary Taubes is a journalist and several real nutritional experts have debunked his nonsense. It’s not an eye-opener. It’s pseudo-science.

Here’s a little from Harriet Hall on that book. A real nutrition expert that was mentioned earlier.

> **[Why We Get Fat](https://sciencebasedmedicine.org/why-we-get-fat/)**
>
> Journalist Gary Taubes created a stir in 2007 with his impressive but daunting 640-page tome Good Calories, Bad Calories.  Now he has written a shorter, more accessible book Why We Get Fat: And What

> [@](#):
>
> One, simple carbs cause huge insulin responses and are preferentially sequestered as fat vs being burned.

No. See post 24. Also this:

> **[Insulin…an Undeserved Bad Reputation](https://weightology.net/insulin-an-undeserved-bad-reputation/)**
>
> I feel sorry for insulin.  Insulin has been bullied and beaten up.  It has been cast as an evil hormone that should be shunned.  However, insulin doesn't deserve the treatment it has received.Insulin: A PrimerInsulin is a hormone...

> **[Insulin: An Undeserved Bad Reputation, Part 2](https://weightology.net/insulin-an-undeserved-bad-reputation-part-2/)**
>
> In a previous issue of Weightology Weekly, I wrote about insulin and how it's been unfairly demonized by many in the nutrition field.  This demonization has been based on a number of misconceptions regarding insulin, its biological effects, and...

> **[Insulin: An Undeserved Bad Reputation, Part 3…MOOOOO!!!!](https://weightology.net/insulin-an-undeserved-bad-reputation-part-3-mooooo/)**
>
> This article represents part 3 of a series on how insulin has been unfairly demonized by many in the nutrition field.  If you have yet to read the first few parts, you can read Part 1 here, and you can read Part 2 here.  In this article, I...

> [@](#):
>
> and do not use artificial sweeteners because of their[supercharging impact on your gut bacteria.

You’re missing a big “may” there. You’re also putting all artificial sweeteners in one basket. A bit about the studies here:

> [@](#):
>
> The scientific community is already starting to pick over the results of this study, and dampen public reaction by putting it into perspective. First, the majority of this work was done in mice, who have a different glucose metabolism, diet, and tolerance than humans. The small study with 7 human subjects is very preliminary, and far from sufficient to conclude that the mice data will be applicable to people.
> 
> The Science Magazine article points out that the study was published in a basic science journal, and that a clinical science journal would probably have been much more critical of their clinical speculations.
> 
> Another potentially serious criticism is that the researchers combined saccharin, sucralose, and aspartame data. It seems highly unlikely that three very different molecules would all have the same effect on gut microbiota. It’s possible that what the researchers are seeing is isolated to saccharin alone, which the research focused on. Earlier trials used aspartame, which had a smaller effect so the researchers switched to saccharin. The Science Magazine article reports:
> 
> _“The authors are confounding their conclusions by addressing all these noncaloric artificial sweeteners together,” says Brian Ratcliffe, a nutrition researcher at Robert Gordon University in Aberdeen, U.K. That’s why the title of the paper, “Artificial sweeteners induce glucose intolerance by altering the gut microbiota,” is misleading, he says. “I cannot believe the journal allowed that title.” Still, he says, the data “certainly does suggest that there is something more that needs to be explored about saccharin."_
> 
> …  
> **Conclusion**
> 
> The current study is rigorous and interesting, as far as it goes. It suggests that saccharin has the potential to alter the gut microbiota of mice and has some relationship to glucose metabolism. It would be interesting to work out the various mechanisms involved with future research.
> 
> The bottom line that is frequently being communicated to the public about this study, however, is not supported by this data, is misleading, and is likely to lead to poor health decisions.
> 
> It is unclear if these results apply to sucralose or aspartame (and therefore diet soft drinks), and it is further unclear if they apply to humans.
> 
> Meanwhile, other studies, some of which are massive epidemiological studies, show a clear connection between consuming sugar-sweetened drinks and type II diabetes, and no connection to drinking NAS sweetened drinks. This study should not motivate anyone to abandon their diet drinks for sugar-sweetened drinks, but the way the study is being reported may do just that.

[Artificial Sweeteners and Diabetes - NeuroLogica Blog](http://theness.com/neurologicablog/index.php/artificial-sweeteners-and-diabetes/)]([Artificial Sweeteners May Change Our Gut Bacteria in Dangerous Ways | Scientific American](https://www.scientificamerican.com/article/artificial-sweeteners-may-change-our-gut-bacteria-in-dangerous-ways/))

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<div class="post-metadata">

**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\
**Post date:** [September 30, 2017, 1:17am UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/37 "2017-09-30T01:17:27Z")

</div>

> [@Jackmannii](#):
>
> _“There is a general perception that almost no one succeeds in long-term maintenance of weight loss. However, research has shown that ≈20% of overweight individuals are successful at long-term weight loss when defined as losing at least 10% of initial body weight and maintaining the loss for at least 1 y. The National Weight Control Registry provides information about the strategies used by successful weight loss maintainers to achieve and maintain long-term weight loss. National Weight Control Registry members have lost an average of 33 kg and maintained the loss for more than 5 y. To maintain their weight loss, members report engaging in high levels of physical activity (≈1 h/d), eating a low-calorie, low-fat diet, eating breakfast regularly, self-monitoring weight, and maintaining a consistent eating pattern across weekdays and weekends. Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2–5 y, the chance of longer-term success greatly increases. Continued adherence to diet and exercise strategies, low levels of depression and disinhibition, and medical triggers for weight loss are also associated with long-term success.”_
> 
> [http://ajcn.nutrition.org/content/82/1/222S.long](http://ajcn.nutrition.org/content/82/1/222S.long)  
> [Weight-loss maintenance for 10 years in the National Weight Control Registry - PubMed](https://www.ncbi.nlm.nih.gov/pubmed/24355667)

One year is not long term weight loss. People losing weight and gaining it back within 1-5 years seems to be the normal outcome.

Also the NWCR selects from the minority who lose weight and keep it off. That isn’t a study of the general public, it is following the minority who succeed at long term weight loss.

Is it possible to lose weight and keep it off permanently solely via lifestyle changes? Yes, but only about 5% succeed.

By comparison, Harvard has about a 5% acceptance rate. So for every 100 people who apply to Harvard, only 5% get accepted. Going to a Harvard campus and saying ‘lots of people get into Harvard’ doesn’t change the 5% acceptance rate.

So is it impossible to get accepted to Harvard? No, lots of people get in. But it is extremely rare.

Either way, with 2/3 of people in middle and upper income nations suffering from overweight, solutions that work 5% of the time aren’t going to fix it. People have preached diet and exercise for decades and obesity rates keep climbing.

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<div class="post-metadata">

**Author:** ![Jackmannii](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/jackmannii/32/311_2.png) [@Jackmannii](https://boards.straightdope.com/u/Jackmannii)\
**Post date:** [September 30, 2017, 3:30am UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/38 "2017-09-30T03:30:16Z")

</div>

> [@Wesley\_Clark](#):
>
> One year is not long term weight loss.

The link I posted (and which you just quoted) said:

_“National Weight Control Registry members have lost an average of 33 kg and maintained the loss **for more than 5 y.** (bolding added)…Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2–5 y, the chance of longer-term success greatly increases.”_

While that doesn’t mean most people have that rate of success, if one goes about weight loss the right way and with good motivations and support, it’s not just a “tiny minority” that keeps significant weight off long-term.  
On the other hand, I heavily doubt that gimmick diets like alternately gorging and starving are anywhere near as successful as what the NWCR reports for “traditional” weight loss techniques.

Speaking of which: there’s evidence that food [can be addictive](http://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/mental-health-food-addiction#1). Are there any other addictions successfully treated by repetitiously overindulging and then abstaining? Do heroin users markedly lower their drug use by shooting up massively one day and then going cold turkey for a few days? Can alcoholics drink themselves into a stupor followed by several days on the wagon and expect to significantly moderate their intake? Does it work for smokers?

I think the problem is evident.

---

<div class="post-metadata">

**Author:** ![Wesley\_Clark](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/wesley_clark/32/20581_2.png) [@Wesley\_Clark](https://boards.straightdope.com/u/Wesley_Clark)\
**Post date:** [September 30, 2017, 9:59pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/39 "2017-09-30T21:59:39Z")

</div>

My point is this. The NWCR selects from the minority who actually lost weight and kept it off. If you have 1,000,000 people try to lose weight, and 50,000 succeed in keeping it off permanently then there are a ton of people who kept it off. But 95% of people didn’t.

We really don’t know why they lose weight and keep it off. I’ve seen studies where people who are more successful at long term weight management do not experience the same level of endocrine disruption as other people who lose weight. Identical twin studies show people lose and gain weight at different rates if you overfeed or underfeed them, maybe the 5% are more genetically prone to keeping the weight off. We don’t know how it works, if we did we’d have solutions.

Has anyone done a study where they took advice from the people in the NWCR, and got a group of 10,000 random people to lose weight and then keep it off for 5 years following their advice? Has anyone conducted a study using the advice gained from NWCR to get a statistically significant group of people to lose weight and keep it off for 5+ years? If they have, what were the results.

If diet and exercise work 5% of the time in permanently curing overweight, then in a nation with 60% of people who are overweight, they may be able to lower their numbers to 57% using diet and exercise. That doesn’t solve the obesity crisis. Even if you can bump the numbers who succeed long term up to 10%, that still would mean 54% of people are overweight or obese.

---

<div class="post-metadata">

**Author:** ![FlikTheBlue](https://sea3.discourse-cdn.com/straightdope/user_avatar/boards.straightdope.com/fliktheblue/32/10972_2.png) [@FlikTheBlue](https://boards.straightdope.com/u/FlikTheBlue)\
**Post date:** [September 30, 2017, 11:00pm UTC](https://boards.straightdope.com/t/question-on-dieting-re-calories-out/797526/40 "2017-09-30T23:00:27Z")

</div>

> [@Jackmannii](#):
>
> The link I posted (and which you just quoted) said:
> 
> _“National Weight Control Registry members have lost an average of 33 kg and maintained the loss **for more than 5 y.** (bolding added)…Moreover, weight loss maintenance may get easier over time; after individuals have successfully maintained their weight loss for 2–5 y, the chance of longer-term success greatly increases.”_
> 
> While that doesn’t mean most people have that rate of success, if one goes about weight loss the right way and with good motivations and support, it’s not just a “tiny minority” that keeps significant weight off long-term.  
> On the other hand, I heavily doubt that gimmick diets like alternately gorging and starving are anywhere near as successful as what the NWCR reports for “traditional” weight loss techniques.
> 
> Speaking of which: there’s evidence that food [can be addictive](http://www.webmd.com/mental-health/eating-disorders/binge-eating-disorder/mental-health-food-addiction#1). Are there any other addictions successfully treated by repetitiously overindulging and then abstaining? Do heroin users markedly lower their drug use by shooting up massively one day and then going cold turkey for a few days? Can alcoholics drink themselves into a stupor followed by several days on the wagon and expect to significantly moderate their intake? Does it work for smokers?
> 
> I think the problem is evident.

The problem is that real world evidence (the rate of obesity) shows the strategy of just cutting back a little on calories every day is not successful. The reason it doesn’t work is not because you won’t lose weight when calories in are less than calories out. The problem is that it’s a very difficult diet to stick to. So the question is not which diet has fewer calories in, or which one has the greater (likely very slight) effect on calories out. The better question is which diet is psychologically easier to stick to. My guess is that it’s actually the first method (feast, eat, eat, eat, fast, fast , fast). But that’s just a guess and it will vary on the individual dieter’s approach to eating.

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