Thread by @DoctorTro

Have you been told to lose weight you need to produce a “caloric deficit”?

Let’s think about why this information is nearly useless.

🚨 THREAD ALERT 🚨

1) despite the proliferation of calorie tracking apps and nutrition labeling and information on products and restaurants, obesity and diabetes have continued to flourish.

KNOWING ABOUT CALORIES HAS SOLVED NOTHING

2) types of food affect the INPUT side of equation.

Try to eat 1000 calories of chicken breast
Then try to 1000 calories of donuts, cereal, cookies, ice cream, pizza, French fries & chips

the palatability & quality of the food modulates calorie input

Cc: @KevinH_PhD

3) the types of foods effect the OUTPUT side of the equation

Foods high in protein (like 🍳🥩🍗🍖🥓🥚🍤🐠🦞🦐) have a higher TEF
Low carb eating particularly in hyperinsulinemia will ⬆️RMR

Cc: @davidludwigmd

4) food addiction can lead to food intake outside of issues related to hunger and food quality, important to gather YFAS/BEDS7 data on all patients

Cc: @lowcarbGP

5) obesity and weight gain and resulting joint disease will reliable lead to decreased leisure time activity, thus hampering the OUTPUT side of the equation

6) glycemic shifts in the setting of hyperinsulemia lead to increased thinking of food reward

7) foods high in sugar independently addictive

8) fat potentials the food reward of sugar

Cc: @wellboy

9) most highly addictive foods are combo of sugar, processed carbs and fat
🍩🍪🌰🍭🍬🍫🎂🍰🧁🍦🥨🥖🥞🥐🍟🍔🥤

10) food companies and restaurants have exploited food reward/addiction

Cc: @MichaelMossC

11) varying diets create unique hormonal and glycemic states that uniquely effect ad lib caloric intake, ie KETO, WFPB, paleo etc.

Bottom line: the calorie in calorie out model of viewing obesity has been a real world failure and in theory has many pragmatic issues.

Focus on appetite, hunger, satiety and all factors LEADING to a caloric surplus, NOT THE surplus which is a symptom.