How is it unhelpful? For the obese, it presents the simplest and most actionable advice that has the highest relevance to their most pressing health problem.
The CICO message has been part of diet advice for decades. If hearing this message in and of itself were helpful, one would expect that we wouldn't be observing the current levels of obesity in the US. The biology and human behavior are more complex than that.
There are simpler explanations. People have no idea how much they consume and frequently underestimate how much they eat. Inaccurate measurement and non-existent tracking systems sabbotage people's attempts at modifying their weight.
This is frequently solved by getting people to buy a food scale and weigh everything they eat for a few weeks and calculating the actual caloric content of their food. Food scales are frequently all people need to make real and persistent changes to their weight.
The biology isn't complex enough that ignoring CICO or telling people that it's wrong is useful or helpful and not harmful.
> People have no idea how much they consume and frequently underestimate how much they eat. Inaccurate measurement and non-existent tracking systems sabbotage people's attempts at modifying their weight.
I agree, and believe this is part of it. People aren't paying attention to what they eat. This is specifically why understanding human behavior is important and that only repeating CICO is not useful.
If people are interested in understanding how metabolism regulation works and finds that it's useful in modifying their diet to help them be healthier, that should be encouraged, shouldn't it? If understanding how different foods affect hunger, insulin levels, diabetes, muscle gain, fat loss, I think that should be a good thing. If someone focuses purely on calories, they can easily deprive themselves of nutrients and hungry, making it hard to keep themselves on the diet and failing to get or keep themselves healthy.
You can't claim that understanding how metabolism works is useful and suggest that understanding how CICO works isn't useful in the same breadth.
Understanding CICO is sufficient to derive all useful, actionable advice for healthy weight management (e.g., maybe you're measuring wrong, stop eating calorically dense foods, eat foods that are more satiating, etc.).
Understanding the difference in how fructose is metabolised compared to glucose is majoring in the minors and is far less likely to help someone achieve their goals.
CICO is the most important factor and the simplest to understand. Suggesting people teach themselves biochemistry and physiology without understanding the basics is silly and far less realistic. Ignoring CICO is setting people up for failure which will discourage compliance and further improvements.
> You can't claim that understanding how metabolism works is useful and suggest that understanding how CICO works isn't useful in the same breadth.
I believe you're misreading what I'm saying: I'm saying that only repeating CICO is not helpful. That itself does not give people the tools they need to be able to maintain health. You yourself point this out in saying it's "sufficient to derive all useful, actionable advice for healthy weight management": Not everyone is able to derive things from first principles.
Perhaps we're talking past each other. I'm more satisfied understanding human behavior and metabolism regulation than only repeating CICO and expecting people to derive everything else from there.
You might be right. I think we agree more than we disagree.
I'm certainly not against giving more advice than CICO and I'm not saying we should expect people to derive things from first principles, just that any method of weight loss that works will be working by CICO and understanding that is far more useful than not, and that it is outright harmful for people to suggest that it doesn't work.
I actually wrote a rather long comment a few months ago about my thoughts for healthy living in general if you wanted to know my thoughts beyond CICO: https://news.ycombinator.com/item?id=14681035
CICO-based treatment has been popular for decades yet the problem has continued to get worse (much worse).
I know it works for some but it has not worked for many more. We can stick our heads in the sand about this or admit that we need to be looking for a better answer.
When it doesn't work for someone, that means they were doing it wrong rather than that they were defying the laws of thermodynamics.
The useful thing to do at that point is to diagnose what they were doing wrong and how to correct for that instead of claiming they were defying the laws of physics.
Just an aside that struck me. The phrase "laws of thermodynamics" when applied to diet has always felt a bit off and I think I put my finger on why. The laws of thermodynamics is used in physics while diet is in the realm of biology or biochemistry. While of course chemistry and biology aren't in opposition to the physics, there's a reason it's useful to treat them separately.
Anyway, none of this is meant as criticism or argument. Perhaps not much more than a personal insight into phrasing.
