Thoughts on Changing Scientific Beliefs: The Death of Calories, and a New Model for Obesity
This post won’t be an in depth discussion of metabolism, weight loss strategies, or current paradigms in obesity, I will briefly touch upon these topics just for general scientific interest at the end. However, they’re largely just used as evidence; evidence for the opposing side in an internal dialog I’ve had with myself. A scientific argument that ultimately, I lost. However, I’m all the better for it.
Science makes progress funeral by funeral: the old are never converted by the new doctrines, they simply are replaced by a new generation. — Max Planck
Part I: Science is a balancing act
It has been said that a scientist shouldn’t be married to his or her hypothesis. I (largely) believe this to be true. Conflict of interest — financial or ego-based — is a major factor in how a research study is designed, conducted, and ultimately interpreted for meaning and relevance. Conflict of interest, however, is unavoidable. Any researcher has an “interest” in what their studying and will be influenced by an intrinsic desire to study a certain phenomenon and see a result in support of their presupposition. I have an interest in exercise and how it might benefit humans in disease and aging. I also believe exercise “works”. But this interest (again, hopefully) doesn’t conflict with how I conduct or interpret results.
The problem occurs when, as I stated before, someone is “married” to a particular outcome or dogma. Refusal to accept ( by “accept”, I mean accept that your research question didn’t meet your apriori expectations) the “null hypothesis” (in essence, a finding of “no difference”) can have consequences. The goal of science is to explain, best we can, phenomena of the world. How do things really work? If someone’s beliefs get in the way, or even worse, completely skew their findings — none benefit. In fact, many may suffer as a consequence of flawed science. Changing your mind, as a doer and consumer of science, is sometimes the only available route.
Early in my science education, I learned an equation. A cut-and dry, and truly too simple (in hindsight) equation to explain how our body processes calories. This dogmatic equation was the supposed easy explanation for weight loss or weight gain.
Textbooks told us that 3500 calories = 1 lb of fat. Where this number came from, I don’t know nor do I have the energy of finding out.
This equation tells us that, if a person say, wants to lose 3 lbs of fat (which, would be 10,500 calories according to our equation) then a requiusite caloric deficit of 10,500 calories needs to be achieved.
How to achieve this? Simple. Eat 500 calories less/day, for 3 weeks (21 days x (-)500 = (-)10,500). Presto, 3 lbs of body fat has melted off. Apply this equation to any weight loss scenario and it makes you wonder how anyone would have trouble losing weight, ever. It’s freaking math.
This equation shaped my belief about how people ultimately gain or lose weight. Weight, it seemed, is totally explained by a model known as “calories in = calories out” (CICO). CICO is governed by Newtonian physics (energy in must = energy out) and is beautifully simplistic. Eat more than you burn, and you’re going to store those extra calories as body fat. Exercise more, and add to the “calories out” of this equation, and tip the scales to favor weight loss.
There are some who can’t keep the “scales” in balance, whose diet favor the “calories in” side of our model. Over time, even a small caloric surplus can result in a large amount of weight gained. #Obesity.
This belief governed how I thought about weight both for myself and for others. When giving advice or suggestions to anyone on how to slim down, my answer was simple — eat less and move more. For the most part, this is still the current dogma among many health professionals. Even the Mayo Clinic website, states on their Counting Calories: get back to weight loss basics page that — “fad diets may promise you that avoiding carbs or eating a mountain of grapefruit is the secret to weight loss, but it really comes down to eating fewer calories than your body is using if you want to shed pounds.” CICO model at its finest.
The problems with CICO and “eat less, move more” are two-fold. For one — both of these models place the burden of obesity on the individual as the sole factor in weight maintenance. Obesity is the result of a lack of self control — eating too much, exercising too little, and just overall neglecting health. This is how I thought about most overweight individuals — they just can’t control how much they eat. Obesity entirely explained by a model of caloric balance. Why can’t people just understand this, and fix themselves.
The second problem with these models? Simply, they’re wrong.
Recent dialog and mounting evidence (in pt II) suggests that not only are these models wrong, but that they may have contributed to the current epidemic(s) of obesity and diabetes, among other national metabolic problems.
Here, I will tie in my point about changing one’s mind. Presented with sufficient evidence, even in the fact of a concept that I held as law, I have been forced to change my belief about how weight loss works. Having told numerous people (myself included) that this model was necessary and sufficient as an explanation — I had to confront the fact that a vested interest in “being right” (my ego) about what I had advised and argued was less important than starting off on a newer and truer route.
I couldn’t fall victim to the “sunk cost” problem and continue with incorrect beliefs just because I had spent a large amount of my career on the wrong side of this issue. As a scientist, just as a lawyer would, I had to confront the facts, necessary and sufficient, which supported an alternative model of how the world worked. Calories in-calories out, I now see, was all too simple. Obesity is complex.
Complexity however, is not scary. Instead, it’s intriguing. When science is complex, that leaves all the more room to develop interesting hypotheses, test and develop novel interventions, and if one is lucky, find out something that factually beautifully, and fundamentally, explains the world we live in.
Authors note: while I state that CICO is relatively incorrect, in no way do I mean to suggest that the alternative (below) is a “factual, beautiful, and fundamental” explanation for obesity. This problem, among others, is still super complex. Obesity involves too many factors to account for, and we still don’t know truly what “causes it.” What I mean to imply is that, better than simplistic models before, current research is pointing us in a direction that teaks more evidence, science, and data into account. In part II, I’ll discuss the evidence that led to my changed beliefs, and where this puts us today in terms of understanding metabolic health.
