I can’t lose weight…

IS IT HORMONES OR (CICO) CALORIES IN CALORIES OUT?

You are continually asking yourself, is it hormones or (CICO) "calories in vs. calories out" that is keeping me from losing weight. 

When it comes to body composition/ change, there's no topic more popular than (CICO) "calories in vs. calories out."

CICO is when you take in more energy than you burn, you gain weight. When you take in less energy than you burn, you lose weight. This is a fundamental concept in body weight regulation, and about as close to scientific fact as possible. The disagreement about CICO comes when you aren't losing weight anymore. 

People say you are "just eating too much and not moving enough." So often, the simple solution is "move more, eat less." However, that doesn't work all the time, either! "You see…critics say CICO does not account for hormone imbalances, insulin resistance, polycystic ovary syndrome (PCOS), and other health problems that affect metabolism. They often claim certain diets and foods provide a "metabolic advantage," helping you lose weight without worrying about CICO."

My position as a Coach for women is to take an integrative role by looking at all the lifestyle factors and other factors holistically instead of taking an extreme part in dieting.

"Eat less, move more" only considers the calories you eat and the calories you burn through exercise and not other daily movements. 

But CICO is an informal way of expressing the Energy Balance Equation, which is far more involved.

The Energy Balance Equation—and therefore, CICO—includes all the intricate inner workings of the body, as well as the external factors that ultimately impact "calories in" and "calories out."

Often overlooked in CICO is your brainpower. The brain is continuously monitoring and controlling CICO. It is regularly sending and receiving messages that involve your gut, hormones, organs, muscles, bones, fat cells, external stimuli (and more), to help balance "energy in" and "energy out." It's a complicated system.

The actual Energy Balance Equation is simple:

[Energy in] – [Energy out] = Changes in body stores

(Body stores: refers to all the tissues available for breakdowns, such as fat, muscle, organ, and bone)  

With this equation, CICO is dependant on many factors:

• Hormones that regulate appetite

• Type of food consumed, sleep, health 

• Calories absorbed

• Culture, socioeconomic status, stress

• Mindset, control, psychology 

• Body size, age, fitness

• Genetics

• Energy burned during training.

• Non-Exercise Movement (NEAT)

• Energy burned by metabolism, and how processed food is

• Environmental issues

You can estimate your caloric needs with Macro applications; however, other factors will determine your progress. 

As a Coach, I set caloric intake and experiment with each client as their process develops.

For starters, calorie calculators are based on averages and can be off by 20-30 percent in familiar, young, healthy people. They may vary even more in older, clinical, or obese populations. And that's just on the "energy out" side. The number of calories you eat—or your "energy in"—is also only an estimate. For example, the FDA allows inaccuracies of up to 20% on label calorie counts, and research shows restaurant nutrition information can be off by 100-300 calories per food item.

What's more, even if you accurately weigh and measure every meal you eat, you still wouldn't have an exact "calories in" number. That's because there are other confounding factors, such as:

• We don't absorb all of the calories we consume. And absorption rates vary across food types. (Example: We drink more calories than estimated from fibre-rich foods, and fewer calories than estimated from nuts and seeds.)

• We all absorb calories uniquely based on our gut bacteria.

• Cooking, blending, or chopping food generally makes more calories available for absorption than may appear on a nutrition label.

Of course, this doesn't mean CICO doesn't work. It only means the tools we have to estimate "calories in" and "calories out" are limited.

To be clear: calorie calculators can still be beneficial for some people. But it's essential to be aware of their limitations. If you're going to use one, do so as a rough starting point, not a definitive "answer." 

I use calorie counting to help my clients develop an awareness of how much their body needs to consume to get the results they want. The macro numbers are an estimate to increase or decrease food. The other two techniques I include are; hand portions and eating slowly.

However, there is no way of getting around if a client is not losing weight. We need to either decrease or increase energy in and out, coupled with stress resilience techniques, sleep hygiene, quality of food, frequency of training and meals, supplements and tracking. Sometimes the solution to weight loss and obvious and other times they are not.

Some possible reasons you think CICO is no longer working, but essentially, CICO has just shifter to current health/lifestyle status. 

• Slight increases in food intake due to changes in mood, hunger, or stress.

• An increase in the amount of Energy absorbed—caused by new medication, an unknown medical condition, or a history of chronic dieting.

• Physiological changes that resulted in fewer calories burned during exercise and at rest

• The onset of chronic pain, provoking a dramatic decrease in non-exercise activity thermogenesis (NEAT)

• Significant changes to sleep quality and quantity, impacting metabolic output and food consumed.

Its Hormones Debate. Seem like a logical scapegoat for trouble losing weight.

And while they're probably not to blame as often as people think, hormones are intricately entwined with energy balance.

But even so, they don't operate independently of energy balance.

In other words, people don't gain weight because "hormones."

They gain weight because their hormones are impacting their energy balance.

This often happens during menopause or when thyroid hormone levels decline.

Take, for example, triiodothyronine (T3) and thyroxine (T4), two thyroid hormones that are incredibly important for metabolic function. If levels of these hormones diminish, weight gain may occur. But this doesn't negate CICO: Your hormones are positively influencing "energy out."

This may seem a bit like splitting hairs, but it's a meaningful connection to make, whether we're talking about menopause or thyroid problems or insulin resistance or other hormonal issues.

Suppose you're working from the false premise hormones are the only thing that matters. This can lead to increasingly unhelpful decisions, like spending a large sum of money on unnecessary supplements or adhering to an overly restrictive diet that backfires in the long run.

Instead, you know results are dependent on the fact that "energy in" or "energy out" has changed. Now, this change can be due to hormones, and if so, you'll have to make adjustments to your eating, exercise, or lifestyle habits to account for it. (This could include taking medication prescribed by your doctor, if appropriate.)

Research suggests people with mild (10-15% of the population) to moderate hypothyroidism (2-3%) may experience a metabolic slow down of 140 to 360 calories a day.

That can be enough to lead to weight gain or make it harder to lose weight. (One caveat: Mild hypothyroidism can be so mild many people don't experience a significant shift in metabolic activity, making it a non-issue.)

What's more, women suffering from polycystic ovary syndrome, or PCOS (about 5-10%), and those going through menopause, may also experience hormonal changes that disrupt energy balance.

So, it's essential to understand your health status, which will provide valuable information about the unique challenges involved and how you should proceed.

YOUR RESULTS ARE NOT DEPENDANT ON A DIET. THEY ARE BEHAVIOUR DEPENDANT.

Maintaining a healthy body (including healthy body weight) is about developing consistent, sustainable daily habits that help you positively impact "energy in" and "energy out."

This might be accomplished while enjoying the foods you love, by:

• Eating until you're 80% full.

• Eating slowly and mindfully.

• Eating more minimally processed foods

• Getting more high-quality sleep

• Taking steps to reduce stress and build resilience

Once you accept that CICO is both complex and inescapable, you can find comfort in 3 strategies to help you:

1. Consume protein and fibre

2. Shift your perspective about eating; when you are calm and happy, being in a calorie deficit isn't bad. Stop counting down the minutes to your next meal, leaving you feeling deprived. Enjoy each feed as it comes.

3. Add activity, rather than reducing calories. Eating more calories will help you carry more lean mass and less fat. Exercise will send nutrients to muscle and not fat cells.

Win-Win

Reference 

Precision Nutrition 2019