EAT LES. CUT your calories. Watch your portion size. These mantras have formed the
foundation of conventional weight-loss advice over the past fifty years. And the widespread
obesity epidemic proves that this advice has been an utter disaster, perhaps only topped by
the nuclear meltdown of Chernobyl. This caloric reduction advice is based on a false
understanding of what causes weight gain.
What causes obesity? We don’t stop to consider this basic question because we believe
that we already know the full answer. It seems so obvious, doesn’t it? Excessive intake of calories causes obesity. Too many calories in compared to too few calories out leads to
weight gain. This energy balance model of obesity has been drilled into us since childhood.

Fat Gained = Calories In – Calories Out
For the past fifty years, our best weight-loss advice was primarily to restrict our caloric
intake. Specifically, we were told to restrict the amount of dietary fat, which is calorically
dense. This means reducing foods high in fat, such as meat, butter, cheese, and nuts, in order to lower our calorie intake and therefore lose weight. We made food guides, food
pyramids, and food plates to indoctrinate children into this brand-new, low-calorie religion. “Cut Your Calories,” we declared. “Eat Less, Move More,” we chanted.
Nutrition labels were mandated to include calorie counts. Programs and apps were
created to more precisely count calories. We invented small devices such as Fitbits to measure exactly how many calories we were burning. Using all our ingenuity, focused like a
laser beam and dogged as a turtle crossing a road, we cut calories.
What was the result? Did the problem of obesity simply fade away like the morning mist on a hot summer day? In a word, no. The underlying, unspoken premise of this model is
that energy creation (calories in), energy expenditure (calories out), and fat gain are independent variables fully under our conscious control. It assumes that the number of calories used to keep our bodies running more or less normally remains stable and
unchanging. But this is untrue.

The truth is that the body can adjust its basal metabolic rate (BMR)—the energy required
to keep the heart pumping, lungs breathing, kidneys and liver detoxifying, brain thinking,
body generating heat, and so on—up or down by 40 percent. When you eat fewer calories,
your body slows down so it uses fewer calories, which means you don’t lose weight.
This model also completely ignores the multiple overlapping hormonal systems that signal hunger and satiety. That is, we may decide what to eat and when to eat it, but we cannot decide to feel less hungry. We cannot decide when to burn calories as body heat and when to store them as body fat. Hormones make these decisions. The results of the
so-called “caloric reduction as primary” advice could hardly have been worse if we had tried. The storm of obesity and type 2 diabetes that began in the late 1970s has today, some forty years later, become a global category 5 hurricane threatening to engulf the entire world in sickness and disability.

Only two possibilities can explain how obesity could spread so rapidly in the face of our
shiny new advice to reduce fat and calories: first, perhaps this advice is good but people
are simply not following it; second, perhaps the advice is simply wrong.

The idea that the spirit is willing but the flesh is weak—that people have the dream but
not the drive—is as absurd as expecting a drowning man to laugh.
Was the entire obesity epidemic simply a sudden, simultaneous, coordinated, worldwide lack of willpower? The world can’t agree which side of the road we should drive on, yet, without discussion, we all decided to eat more and move less so that we could become undesirably fat? This explanation is only the latest iteration of the game called “blame the victim.” It shifts the responsibility from the advice giver (the advice is bad) to the advice
taker (the advice is good, but you are not following it). By declaring that their scientifically unproven caloric reduction advice was flawless, doctors and nutritionists could conveniently shift the blame from themselves to you. It wasn’t their fault. It was yours. Their advice was good. You didn’t follow it. No wonder they love
 this game so much. To admit that all their precious theories of obesity were simply incorrect
was too psychologically difficult. Yet evidence continued to accumulate that this new caloric
restriction strategy was about as useful as a comb to a bald man.
The Women’s Health Initiative
25 was the most ambitious, important nutrition study ever
done. This randomized trial involving almost 50,000 women evaluated the low-fat, lowcalorie approach to weight loss. Although it was not specifically a weight-loss trial, one
group of women was encouraged through intensive counseling to reduce their daily caloric
intake by 342 calories and to increase their level of exercise by 10 percent. These calorie
counters expected a weight loss of 32 pounds every single year.
When the final results were tallied in 1997, there was only crushing disappointment.
Despite good compliance, more than seven years of calorie counting had led to virtually no
weight loss. Not even a single pound. This study was a stunning and severe rebuke to the
caloric theory of obesity. Reducing calories did not lead to weight loss.
There were now two choices. First, we could respect the expensive, hard-won, scientific
evidence to devise a robust, more correct theory of obesity. Or we could simply keep all our comfortable and convenient preconceived notions and biases and ignore the science. The second choice involved far less work and far less imagination. So this ground-breaking study has largely been ignored and relegated to the dustbins of nutritional history. We have been paying the pied piper every day since, as the twin epidemics of obesity and type 2 diabetes have exploded.

Real-world studies
 have only confirmed this stunning fiasco. The conventional weightloss advice to eat fewer calories carries an estimated failure rate of 99.4 percent. For morbid obesity, the failure rate is 99.9 percent. These statistics would not surprise anybody in the diet industry or, for that matter, anybody who has ever tried to lose weight.

The Calories-In, Calories-Out theory gained widespread acceptance based on its
seemingly intuitive truth. However, like a rotting melon, digging past the outer shell revealedthe putrid interior. This simplistic formula is riddled with erroneous assumptions. The most
important error is believing that basal metabolic rate, or Calories Out, always remains
stable. But a 40-percent reduction in calorie intake is quickly met with a 40-percent decrease in basal metabolic rate. The net result is no weight loss. The other major false assumption is that weight is consciously regulated. But no system in our body functions like that. The thyroid, parathyroid, sympathetic, parasympathetic, respiratory, circulatory, hepatic, renal, gastrointestinal, and adrenal systems are all closely controlled by hormones. Body weight and body fat are also strictly regulated by hormones.

In fact, our bodies contain multiple overlapping systems of body weight control. Body fat, one of the most important determinants of survival in the wild, is simply not left to the vagaries of what we decide to put in our mouths.

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