Should Calorie Counting Be the Main Focus for Somebody Trying to Lose Weight (Body Fat)?

Written by Tommy Wood MD, PhD

May 30, 2017

This blog post originated as a short piece that we sent out in one of our weekly “highlights” emails. While there was a temptation to expand on every thought (and risk turning it into a review paper), we decided to post it on the blog in its original form. As you’ll see, our collective experience at NBT suggests that if you purely restrict calories from your current baseline, sustainable weight loss is very difficult to achieve. However, if you instead fix diet quality and troubleshoot the way people interact with their food and their environment, fat loss occurs spontaneously. Regardless of where you stand on the issue, perhaps we can get a good discussion going that we will all learn something from!

Should calorie counting be the main focus for somebody trying to lose weight (body fat)?

This is a decades-old question with many proponents on both sides of the argument. Recently, we had a conversation with Chris Masterjohn (CM) about the underlying causes of the obesity epidemic, and the best approaches to weight loss. Two different approaches immediately transpired - one of calorie counting (CM) vs one of changing the environment (Tommy). CM’s personal approach has since been expanded upon in a recent video, where he details a plan to lose weight by finding your current calorie intake and initially cutting 500 calories per day.*

At NBT, we have long been proponents of avoiding calorie counting (unless we’re trying to get an athlete to eat more calories). This is because simply receiving advice to eat less of the same food doesn’t really work well to produce significant weight loss in the long-term. Especially when most modern foods are specifically designed to be overeaten. You might be able to get better results during calorie restriction by joining a group of like-minded people for moral support (i.e. something like Weight Watchers), but even then the average total weight loss after 12 months is perhaps around 5-10lbs, and is likely to be regained over time.

In our experience, somebody who is young and healthy (with a strong force of will) can do very well by purely restricting calories. But a problem immediately arises when a person is already eating 800-1,200 calories per day and still failing to lose weight. And yes, we see this fairly frequently. If your first response as a coach is to tell them to cut their daily calorie intake by 500, the only result you’ll get is a very unhappy client. In theory it should work, but very frequently it doesn’t. This is because it doesn’t address the fundamental underlying question:

What caused the weight gain in the first place?

We’re certainly not going to argue that being in excess energy balance is a key determinant of weight gain, and that you need to find a way to sustainably produce an energy deficit to get long-term weight loss. However, the problem with calorie counting is that there is a huge inherent error in the method. For instance, depending on who you ask, the quality of the diet, and whether food is raw or cooked, the “calories” (or energy availability) from a given food can vary dramatically, and perhaps by up to 50%! How we can then accurately apply the calorie content listed on food labels to our own eating goals is beyond us. Calorie counting also doesn’t take into account the effect that those calories will have once in the body in terms of both the hormonal responses and relative energy production.

Energy production is an aspect that gets ignored by calorie counting. Much like calorie counting, it’s not necessarily an exact science, but something that becomes increasingly important if we go to extremes of macronutrient composition (i.e. less than 10% of calories from fat or carbohydrate). By using the food quotient, Alessandro Ferretti and Weikko Jaross (with Paul Itoi and his team at Senza) have made the very cool MitoCalc to estimate calorie requirements based on macronutrient ratios. To show how this can introduce huge error into pure calorie counting, I used my own data to calculate target calorie ranges using either a true low fat (30g fat per day) or ketogenic (70g carbohydrate per day) dietary pattern. The “traditional” estimate is based on the Katch-Mcardle calorie estimator for somebody eating a Western diet:

Baseline data: Weight = 98kg (215lb), Body Fat = 12%, Activity Level = 1.

 

Low Fat

Keto

Protein (g)

155g

155g

Carbohydrate (g)

Balance (~335g)

70g

Fat (g)

30g

Balance (~135g)

Traditional Estimate

2,233

2,233

MitoCalc Calorie Target (kcal)

2,467

2,133

Difference (kcal)

+234

-100

Just by switching my macronutrient balance, my calorie requirements may change by at least 10%! Note that I’ve assumed no activity modifier, because predicting individual responses to activity, and how that affects caloric requirement, gets really tricky (especially depending on whether you assume an additive or constrained model of energy expenditure). With increasing activity, the differences in MitoCalc calorie target between the low fat and keto approaches would be even larger. This adds yet another layer of complexity to the calorie count! Even if the estimates aren’t perfect yet (if anybody can do it, they can), you can still see how powerful this tool is in highlighting the importance of taking macronutrient balance into account when looking at calorie intake.

The hormonal response to food can also be dramatically altered without changing the calorie or macronutrient content. This will fundamentally change the way the body handles the food. For instance, the way in which wheat is processed can result in very different insulin responses despite identical carbohydrate contents and similar ratings on the glycaemic index. If the insulin response to a meal is greater despite the same macronutrient content, it is more likely that energy in that meal (especially the fat content) will be stored. While in the short term this may not have a large effect, it will certainly add-up over time. Insulin is very good at increasing fat storage (better than at affecting blood glucose levels), and the composition of body fat stores largely reflects dietary fat. Therefore, highly-processed carbohydrates plus a large fat load are a killer combo, AKA The Cheesecake Effect. The upshot of this is that improving food quality should undoubtedly come before calorie counting, which will minimise the hormonal and metabolic disturbances caused by meals. Whether this comes from a plant-based, low-carb, ketogenic, or a “Mediterranean” diet, we’re not sure it really matters - just focus on eating real, whole foods that minimise the processing of both carbohydrates and fat. Increasing protein intake during the weight loss period is probably also going to be beneficial. Importantly, if we focus on food quality first, taking whole foods and cooking them ourselves, we can start to regain the lost connection with what food is supposed to be, which is exactly what got us all in trouble in the first place!

So, if calorie counting is fraught with so many pitfalls, perhaps we should instead remember that our bodies are smart enough to control adequate calorie intake, if allowed to do so. If you eat too much one day, your hunger should automatically be suppressed until you’ve reduced calorie intake to match up with the previous excess. That’s how the body is supposed to work! All you need to do is remove it from an environment where the response is to naturally eat more and store more. After you’ve fixed food quality, look at the other aspects of the environment that can lead to lead to overeating or weight gain, and a failure to achieve sustained weight loss:

While each of these deserves a post in their own right, one overlooked factor is the effect of stress and inflammation on mood. If you’re struggling with some kind of chronic inflammatory process, the resulting effect on the brain (i.e. feeling like crap) may make it much harder to enact positive change. This should be addressed before worrying about weight loss.

Finally, and much more important than all of this, is WHY we want to “lose weight”. For most people, the number on the scale is a target just because of what they hope to achieve at their target weight. But as Jason Seib puts it: “nobody cares about the force you exert on the earth due to gravity”. Your weight tells you nothing about your body composition, your health, or your ability to play with your kids. That last thing, particularly, is a goal that we hear more and more frequently from our clients. Staying energetic and functional is something we all want to do, and keep doing, as we get older. And if that’s the case, moving away from calorie counting and fixing the environment is almost certainly going to give bigger, better, and more sustainable results!

*Disclaimer: we certainly don’t intend to disparage Chris Masterjohn. Quite the opposite - we love him! Our respective approaches to weight loss may simply be due to the difference between the academic and clinical perspectives. When it comes to micronutrients and nutritional biochemistry, nobody does it better than Masterjohn. In fact, we thoroughly believe you should sign up for his membership site to learn from him and support his work.

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