To cut to the chase: Do calories matter? Yes, of course they matter. But I view calorie consumption more as an effect, rather than a cause. "Calories In - Calories Out" is certainly true - but it only describes the situation -- it doesn't explain it. As my husband says, "it should be the beginning of the conversation, not the end of it".
As I wrote recently in the First Month of a Low-Carb Diet, a low-carb diet creates a lower demand for calories in the diet (the body gets some of them from our fat stores instead). Because of this, we don't need to worry so much about the supply of calories to the body, at least early on. People experience this change in appetite as being very liberating - for example, they may speak of "feeling normal" around food. Now, we can have arguments as to why low-carb diets seem to normalize appetite regulation -- the appetite system is quite complex. Suffice it to say that there is ample evidence that carbohydrate reduction affects many of the hormones involved in appetite and weight regulation. In other words, it causes us to consume fewer calories.
However, there is a difference between how the body acts in the short term in regards to appetite and weight regulation, and how it works once weight loss gets to a certain point (that point varies probably due to a number of factors, including percentage of body fat lost, how long the person has been losing weight, and a tremendous amount of individual variation). The problem becomes that weight loss itself often begins to trigger the desire for more food. At that point, to maintain the weight loss, it becomes more important to pay attention to intake. Sometimes people find that diet adjustments can help get their appetites back on track, while others have the choice of either gaining weight or dealing with the calorie question.
To tell you the truth, I blame the diet books for some of this. I know it doesn't sell books to tell people that there may be limits to the diet in question, but when people aren't warned, they can possibly let an opportunity slip by.
For myself, I lost weight eating a low-carb diet for 19 months, although the last 8 months I was only losing about a pound a month. (Interestingly, I once heard an obesity expert say that 19 months is the longest a person on a weight-loss diet would keep losing weight. I was stunned to hear this, since it was exactly how long I lost weight.) At that point, I thought I was stalled, but I wasn't really prepared for the possibility of re-gaining the weight, which is what slowly started to happen, even though I was eating the same amount of carbohydrate. I ended up regaining about half of what I had lost. My weight then stabilized and has been pretty much exactly the same ever since -- over 10 years now. Before I started eating low-carb, I had been steadily gaining weight, so I probably would be much heavier if I had not cut carbs. Would I have been able to maintain the greater weight loss if I had been more vigilant? I simply don't know. I'm not someone who is really willing to battle chronic hunger, day in and day out. It simply takes way too much mental energy, which I would rather use for other things (yes, it turns out that mental energy is literally a limited resource). On the other hand, there may be a point at which it's easier to intervene, and I may have let that point slip by because I was unprepared for it. I do know people who were able to successfully intervene at that point by monitoring calories, and have maintained their weight loss that way. Once the weight is regained, it becomes much, much harder.
Remember I said that I think of calorie intake as more of an effect than a cause? I truly think it's mostly biologically determined. A very smart person recently wrote that we regulate our internal temperature mainly by our behavior. And yet, we maintain that temperature to a very fine degree most of the time. Throughout most of human history, people probably tended to pick up a few pounds in middle age, but didn't tip over into being overweight or obese. Otherwise, their weights were totally stable. Think about that: if your weight is stable from year to year, you are in balance within 10 calories per day. If you think we have conscious control over calorie regulation, this is quite astonishing, really. This is a few extra steps. This is a slight change in metabolism. Two eggs out of the same carton can easily vary by this much.
A lot of smart people think they know why our "weight thermostats" stopped working right, but they all think different things. It almost certainly is not just one thing (although I tend to think that sugar/refined carbs had a hand in it). Some people think something goes wrong in the system that regulates fat, encouraging us to accumulate more. Then we consume a few more calories to support that slightly larger body.
One great thing is that by losing a small amount of weight, we may lose a significant amount of the visceral fat which is certainly the most dangerous, and this is why keeping a modest amount of weight off can improve so many aspects of health, even for the overweight. This is why for me the focus on health has been so important, and low-carb eating is key for maintaining that weight loss, as well as normal blood pressure, blood lipds, blood glucose, etc.
Image © Emily Dolson
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