Is It Really Just Calories In, Calories Out? Metabolism, Insulin, Hormones and Why Counting Fails

Is weight loss really just Calories in, Calories out? The equation is true, but "just count your Calories" is bad advice for most people, and almost every objection to it is pointing at something real. In part two of our energy balance series, Jordan Feigenbaum takes the biggest "it's not Calories, it's ___" claims (metabolism, thyroid, cortisol, PCOS, insulin, the type of food) and tests each against the best evidence. The verdict: none of them breaks the equation. Every one is a hand on a lever that moves Calories in or Calories out, not a hole in the math.

In this episode: why your metabolism does not crash at 40, how small real metabolic adaptation actually is after weight loss, why hypothyroid weight is mostly water, what the cortisol and PCOS (now PMOS) data show, how absorption and cooking move Calories only at the edges, why even dietitians miscount their own intake, and why the carbohydrate-insulin model fails three tests, including the GLP-1 drugs that raise insulin and still produce the biggest weight loss we have ever approved.

Part two of three: willpower, Calories in Calories out, then GLP-1 drugs. Next week: are GLP-1s cheating?

Timestamps

0:00 Is it really just calories in, calories out?
0:18 The willpower episode and the through-line
2:10 Thermodynamics: what sets both sides
2:41 Your metabolism is three things
4:05 Claim 1: my metabolism crashed
4:24 No cliff at 40: the doubly labeled water study
5:33 Real metabolic adaptation after weight loss
6:56 Why your food diary lies
7:49 Claim 2: it's my hormones
8:07 Thyroid: mostly water
9:36 Cortisol: explains about 1 percent
11:12 PCOS is now PMOS
13:06 Menopause
14:18 Claim 3: a calorie isn't a calorie
16:48 Absorption: nuts, cooking, eggs
19:44 Why calorie counting fails
21:12 Claim 4: it's not Calories, it's insulin
22:02 Testing the carbohydrate-insulin model
25:52 The GLP-1 drugs that should end it
28:34 The whole list, claim by claim
29:53 What to actually do
30:42 Next week: are GLP-1s cheating?

Resources:

Barbell Medicine coaching and templates: https://www.barbellmedicine.com

https://www.barbellmedicine.com/shop/subscriptions/plus-podcast-subscription/

https://www.barbellmedicine.com/shop/subscriptions/barbell-medicine-premium/

Signal book pre-order: https://www.barbellmedicine.com/shop/learning/signal/

Pontzer et al., Science 2021. https://doi.org/10.1126/science.abe5017

Muller et al., Am J Clin Nutr 2015. https://doi.org/10.3945/ajcn.115.109173

Lichtman et al., N Engl J Med 1992. https://doi.org/10.1056/NEJM199212313272701

Karmisholt et al., J Clin Endocrinol Metab 2011. https://doi.org/10.1210/jc.2010-1521

Lee et al., Endocr Pract 2014. https://doi.org/10.4158/EP14072.OR

van der Valk et al., Obes Rev 2022. https://doi.org/10.1111/obr.13376

Nikokavoura et al., Diabetes Metab Syndr Obes 2015. https://doi.org/10.2147/DMSO.S85134

Greendale et al., JCI Insight 2019. https://doi.org/10.1172/jci.insight.124865

Lejeune et al., Am J Clin Nutr 2006. https://doi.org/10.1093/ajcn/83.1.89

Bray et al., JAMA 2012. https://doi.org/10.1001/jama.2011.1918

Novotny et al., Am J Clin Nutr 2012. https://doi.org/10.3945/ajcn.112.035782

Baer et al., J Nutr 2016. https://doi.org/10.3945/jn.115.217372

Baer et al., Br J Nutr 2012. https://doi.org/10.1017/S0007114511002649

Evenepoel et al., J Nutr 1998. https://doi.org/10.1093/jn/128.10.1716

Hall et al., Cell Metabolism 2019. https://doi.org/10.1016/j.cmet.2019.05.008

Champagne et al., J Am Diet Assoc 2002. https://doi.org/10.1016/S0002-8223(02)90316-0

Hall et al., Cell Metabolism 2015. https://doi.org/10.1016/j.cmet.2015.07.021

Wilding et al., N Engl J Med 2021. https://doi.org/10.1056/NEJMoa2032183

Jastreboff et al., N Engl J Med 2022. https://doi.org/10.1056/NEJMoa2206038

Our Sponsors:
* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com
* Check out FIGS and use my code FIGSRX for a great deal: https://wearfigs.com
* Check out Factor and use my code factormeals.com/bbm50off for a great deal: https://www.factor75.com
* Check out Quince and use my code BBM for a great deal: https://www.quince.com
* Check out Ten Thousand and use my code PODCAST15 for a great deal: https://www.tenthousand.cc

Advertising Inquiries: https://redcircle.com/brands

Denne episoden er hentet fra en åpen RSS-feed og er ikke publisert av Podme. Den kan derfor inneholde annonser.

Episoder(448)

Is It Safe to Train When the Air Is Full of Wildfire Smoke?

Parts of the country now get a few weeks of wildfire smoke every year, and the obvious question is whether there is a point where the air is bad enough that the workout costs you more than it gives yo...

24 Sep 37min

Do You Need a Calorie Surplus to Build Muscle? | Dr. Eric Helms

Most lifters have been told they need to eat in a Calorie surplus to build muscle. That rule has always come with a list of exceptions: unless you're new, unless you're carrying extra body fat, unless...

17 Sep 2h 1min

Is Obesity A Muscle Problem?

Muscle is where most of the glucose goes, and muscle insulin resistance is the first thing that breaks on the road to type 2 diabetes. Both of those are true, and neither one means that building more ...

4 Sep 1h 17min

Who Needs Testosterone, and Who's Not Getting It I Signal Episode 4

Most men who start testosterone never needed it, and some who genuinely do never get treated. In the final episode of the Signal series, Dr. Jordan Feigenbaum and Dr. Austin Baraki work through who ac...

27 Aug 1h 26min

Your Fat Has a Storage Limit

In 2004 a surgeon removed about ten kilograms of fat from fifteen women and measured everything that mattered. Nothing improved. Four years later, it still hadn't.That result should have ended an argu...

20 Aug 49min

Lifting and longevity: is 1 hour a week really the limit? Plus GLP1s and mood, training with ME/CFS, and Protein vs. Calories

A popular paper claimed the longevity benefit of lifting disappears once you train more than an hour a week. It's a real paper, but the claim is a misread. This is the free cut of this month's Direct ...

12 Aug 46min

The FDA Voted for 6 Peptides. Its Own Scientists Said No

An FDA advisory committee just voted to open a legal compounding supply line for six of seven peptides, including BPC-157 and TB-500, over the objection of the FDA's own scientists, who recommended ag...

7 Aug 1h 6min

The Man Who Couldn’t Stop Gaining Weight | A Medical Mystery

A previously healthy 21-year-old shows up with seven months of headaches and 30-plus pounds of weight gain he can’t explain. He’s eating the same and training more, and the scale climbs anyway. We han...

31 Jul 1h 10min