THe Complexity of Weightloss

[4StrandKnot]

The concept of food noise is revolutionizing obesity research.

https://www.nytimes.com/2026/04/27/health/food-noise-obesity-drugs-glp-1.html?smid=nytcore-ios-share

 

[sheilarae74]

I started estrogen and got an IUD with progesterone before starting tirz. I have been able to lose a lot of weight, but I also had to stack with reta to get close to goal. On tirz alone, I got so very stuck and feared I was cursed. I broke the stall but I'm still 10-20 lb from goal, even after 13 months.

I absolutely would not stop HRT. I watched both my grandmothers suffer horribly and eventually die on dialysis because of complications of vaginal atrophy. First, UTI after UTI, then bladder infections, then kidney infections, then kidney failure, dialysis, and death. It was all so very preventable but the taboos about vaginas were apparently important to some people with louder voices than me.

DO NOT STOP THE ESTROGEN. (link to a study)

That is horrible what happened to your grandmothers. I count myself lucky that I survived menopause without needing HRT.

 

[Just A Cat]

It was all so very preventable but the taboos about vaginas were apparently important to some people with louder voices than me.

Women's health takes the backseat. Even in 2026 that is still true.

 

[AngieHolmes 53745]

Except, I am not entirely arguing in favor of CICO.

You cannot forever cut calorie intake. Lets say you have an unusually low metabolism of 1400kcal for whatever reason. You cannot realistically eat 900kcal every day to lose weight. It's a miserable and unsustainable way of living. Even if you do, our basal metabolism will reduce as one loses weight, and there is a good chance it will rebound.

The problem with CICO is not the math. I t is the real life constraint that we cannot forever eat less and less until we eat like literal ants.

I don't think I've eaten 900 calories in a single day this year. Most days I'm doing well to hit 500. I'm not miserable at all; I'd eat less if I weren't pushing myself. Due to pre-existing health issues I'm inactive to the point of stationary. (A year ago I was doing much more.)

I'm terrified of what would happen if GLPs went away; I assume I'd balloon up to a fatty blob. It's why I have a large supply. I'm not sure if I'm proving your point, or the opposite ; )

 

[Charles Lewis]

That’s quite a journey, and congratulations on getting to one of your lowest weights! I think a lot of people here can relate to that fear of regaining the weight after working so hard. Glad you’ve found something that’s working for you, and welcome!

 

[Faberhome22 54708]

but I honestly believe that most people have no idea how many calories they really eat and how many they potentially need. Just had a conversation last night with a family member and said that there are 3,500 calories in a pound of fat. She had no idea that pounds could be quantified in calories. She also didn’t realize her TDEE is 1,400 calories while mine is 2,600. When we eat lunch together we’re eating the same amount of food …

there are studies that show that most people underestimate their calorie intake by as much as 40%. Even a study that used dieticians, who you would think would have this nailed, were under by 20%. the "all or something podcast" did a great breakdown on the studies done.

 

[Grogu]

there are studies that show that most people underestimate their calorie intake by as much as 40%. Even a study that used dieticians, who you would think would have this nailed, were under by 20%. the "all or something podcast" did a great breakdown on the studies done.

I could definitely see this. I’m not tracking my calories right now, but did for a long time. But even now, I measure portion size for new foods I haven’t eaten before just so I have an idea of the calories.

 

[HereKittyKitty]

I don't think I've eaten 900 calories in a single day this year. Most days I'm doing well to hit 500. I'm not miserable at all; I'd eat less if I weren't pushing myself. Due to pre-existing health issues I'm inactive to the point of stationary. (A year ago I was doing much more.)

Is there any way you can increase your caloric intake? 500 kcal/day is incredibly low. I would even say dangerously low.

I saw a dietitian under my insurance some years ago. She was helpful to identify ways to improve my nutrition when a medication I was taking yielded constant nausea and food aversion (for more than a year).

 

[Isabella Rogers]

Sounds like you have really been through the wringer with weight loss over the years. It's great that you are finally found something that's helping and that you are feeling more comfortable with your progress. And honestly, having a supportive community makes a huge difference. Wishing you continued progress

 

[Seasonal1]

there are studies that show that most people underestimate their calorie intake by as much as 40%. Even a study that used dieticians, who you would think would have this nailed, were under by 20%. the "all or something podcast" did a great breakdown on the studies done.

I used to have a treadmill for walking that would provide a wildly high estimate of calories burned for a 30 minute walk. An over-estimate of calories burned by exercise isn't helpful either.

 

[AngieHolmes 53745]

Is there any way you can increase your caloric intake? 500 kcal/day is incredibly low. I would even say dangerously low.

I saw a dietitian under my insurance some years ago. She was helpful to identify ways to improve my nutrition when a medication I was taking yielded constant nausea and food aversion (for more than a year).

It's a problem, I agree. Your solution is a good one. I'm working on it. A bad combo of internal issues that are taking time to resolve. Leading to exhaustion, which makes seeing a nutritionist more challenging, even though getting help with nausea and food aversion is part of what I need right now. I'm focused on getting in as much nutrition and calories as possible.

I finally started treatment for a UTI which has probably been going on for a while and making everything worse including a brain fog problem. I've made a couple mistakes. Had I known I didn't have to go in to the facility for a dx and abx I'd have saved myself days of trouble, but my brain wasn't working. It presented differently than I'm used to and I just wasn't putting things together.

I'm grateful to have a talented and generous doc following me right now. So I'm in good hands, as long as I can make sure to tell her what's going on. My husband is a big help too. Somehow I let myself get way too run down. I feel like I've turned a corner and have a slow climb ahead of me. Thanks so much for your concern and suggestion

 

[HereKittyKitty]

I'm glad you have a good doctor and a good husband.

It happens that life overtakes us sometimes. Sounds like you are on the upswing. I love that for you. One step at a time, you will get back to yourself. Hang in there! You're on a positive path.

 

[AngieHolmes 53745]

Thanks. Appreciate you.

 

[lessthanhalf]

It is perfectly possible to get a fairly accurate measurement of calories in and out. I do not think calorie counting is a great solution to obesity, especially over the longer term, but it can be useful to find out the basic facts of your personal physiology.

Measuring calories in just requires a 100% accurate food diary for a week, including weighing everything, then work out the number of calories or get chatgpt to do it for you, few hours of work.

No estimates of energy expenditure are accurate enough to actually be useful and are often especially useless after weight loss. But you can weigh yourself. It needs to be over a while to be accurate and exclude the effects of shifts in fluid balance, so maybe over a month or 2. Then the weight lost in kg x 7700 kcal is the total deficit in that time period, does not account for lean mass losses, but still much more accurate than any online calculator. And divide by the number of days to get daily deficit. And if there is weight gain instead it can be used to calculate calorie excess. The advantage of this is it cannot be cheated, and is the most accurate method outside a lab that I know of. Not going to work in some situations, if trying to build muscle and lose fat, with a diet that is close to EE requirements and doing lots of exercise for example. But in more severe obesity states it is pretty good.

Usually when an estimate of EE is used it just results in numbers that do not add up, as there is huge individual variation in EE depending on age, weight, height, activity levels, metabolic state, pre or post weight loss etc. When combined with the average persons very inaccurate calorie counting , it explains why CICO seems to not work. It does, always, but that does not make it a good long term strategy.

 

[Just A Cat]

Just a counter point. I am currently tracking everything I eat, but not for calories. I will also say that thankfully this tracking is not forever. I so agree with the "this should not become a lifestyle" comment.

I am tracking everything I eat and putting it into cronometer. I get calories, but I find the macro ratios of protein vs fat vs carbs more important. Keeping the protein high is very important. I had no idea a year ago how much protein is directly tied to muscle loss and muscle preservation.

On the nutrition side, I usually go for protein + fat (a relaxed keto diet) most days. For health, I need to do a Protein + Carb (refeed) day 3 to 4 times a month (every 7 to 10 days).

If you jump into the world of insulin signaling you will come across one hard rule of biology. You never let Fat and Carbs go to the same party together. When those two get together, it leads to the production of fat. So every day must be protein for muscle plus one (but never both) of the remaining trouble makers (fat or carbs.)

There are several things I must track for the next 6 months or so. Mostly it is certain Vitamins that need to be micro managed for a while. Well, it is the same amount of work to track 5 things than it is to track the entire RDA database with modern technology. So what the heck. The entire RDA database it is.

Now I can scan this list and see what is low, but there are ratios that are good to stick to and other little things that are tricky so I also let AI look over the reports. It tells me what is not optimal and we work on ways to fix it. I actually managed to get the worst offender (potassium) goal met for the first time today. But, I forgot about something else so I dropped one of the other juggle balls. Oh well, it is a learning process after all.

Most of you will never want or need to do this, but with modern technology it is actually easier than it sounds. I am driving this crazy train but I see where someone who was hands off could do the same process and only be a train passenger.

So yes, I have all this calorie counting data that I can access in seconds. And I ignore those calories 98% of the time. Fixing nutrition holes is teaching me to pick better food choices. Monitoring RDA is teaching me to fix my body and build a nutrition shield that I will carry with me to prevent future issues. I could do a half decent job of choosing food at this point, but I still have a lot to learn. Since I need to get a few things fixed in my metabolism before I can quit tracking, I might as well ride this crazy train all the way back to the station. The next CE seminar on food choice will be held at 11am today and the mandatory test will be in the dining car at noon.

--Just A Cat who is currently a part time Crazy Train Conductor.

 

[lessthanhalf]

I generally agree with that, controlling types of food eaten is a viable strategy, and is a much more sustainable process over the longer term than calorie counting. It worked for me to lose 70kg without glp's, in 2022-23 just very high protein , very low fat, low calorific density, ideally 1kcal/gram or less, and absolutely zero high glycemic index carb/rich/rewarding/addictive foods, much more extreme in the restrictions, and much less finely detailed, but without the tracking, basically nothing I ate could cause weight gain , as you just could not stuff enough in to get too many calories if the calorific density is low enough, and there is lots of protein. Almost entirely lean meat, fruit and vegetables. And the total avoidance of rich foods was to keep me feeling like low calorie dense food was food, eating rich foods resets your expectations, making low calorie foods taste like not much, and to avoid triggering binge eating. I was still hungry a lot of the time, but at least it was possible to stick to it, and avoid binging, and stay on for another 3 or so years, though now the glp drugs help with being hungry all the time.

 

[jpru2001]

Really good discussion in this thread.

Things I believe based on my sample size of one person losing alot of weight twice in their life, right now being the second time. First time the old fashioned way, this time half the old fashioned way and the latter half with the assistance of reta.

I believe in CICO in general. The calculators aren't accurate for many individuals for sure. But the times I have counted calories, kept a spreadsheet, adjust my estimated TDEE based on counted calories and weight loss results over time, the TREND becomes predictable based on CICO.

A couple caveats:

I say TREND because I also believe in whoosh theory. For me I do think your body will do something with water weight (I don't know if the prevailing theory it is filling emptying fat cells with water is what is happening or not), but quite often I will not lose weight for 2-4 weeks doing the exact same thing as I have been doing, then over a matter of a few days will lose 3-5 pounds (along with a lot of peeing), and what do you know when you look at average weight loss on a weekly basis you are right back on the trend.

I do somewhat believe in set point. Both times I have lost a ton of weight, while being consistent with diet and exercise, I have stalled at the upper 220s and at 190-192. Scale does not move for 4-6 weeks at all. Then it starts back. I don't know why, but it happened both times at each weight. I just now busted through 190 after weeks of no movement this time around (it was a good week!)

Not arguing with anyone on any point, just stating my observations for the good of the discussion.

 

[Skidude]

Very few people would wish to weigh food and calorie count for the rest of their days.

I am hoping that learning to make better food choices will allow me to just fix a meal and eat, in the future.

I am at that stage now, with the help of my friend Tirz and making better choices..

For over a year, I have not weighed or counted. Just did it until I hit goal.

 

[lessthanhalf]

Very few people would wish to weigh food and calorie count for the rest of their days.

I am hoping that learning to make better food choices will allow me to just fix a meal and eat, in the future.

Having lost most of the weight from 145 to 75 kg pre glp drugs and keeping it off for a year, then starting GLP's. I found that it is very close to possible to do just that, where appetite starts to match the number of calories in, but only with the help of GLP drugs. In my case 55% down with tirz15/reta6/cagri0.5mg/week. It might be possible to do it with diet choices alone long term, but not very likely if the obesity is severe.

Without GLP drugs trying to maintain weight loss was very hard, and I was hungry a lot of the time and nearly always eating less food than my body was telling me to, despite a diet carefully designed to reduce hunger, low calorific density, very high protein 40-50% of calories, very low fat and absolutely zero high glycemic index carbs/rich/rewarding foods.

 

[Goonwise]

Having lost most of the weight from 145 to 75 kg pre glp drugs and keeping it off for a year, then starting GLP's. I found that it is very close to possible to do just that, where appetite starts to match the number of calories in, but only with the help of GLP drugs. In my case 55% down with tirz15/reta6/cagri0.5mg/week. It might be possible to do it with diet choices alone long term, but not very likely if the obesity is severe.

Without GLP drugs trying to maintain weight loss was very hard, and I was hungry a lot of the time and nearly always eating less food than my body was telling me to, despite a diet carefully designed to reduce hunger, low calorific density, very high protein 40-50% of calories, very low fat and absolutely zero high glycemic index carbs/rich/rewarding foods.

I think there are some research on body set points and how the fat cells actually work to accumulate fat again.

Some people recommend coolsculpting after weight loss for killing off the fat cells so they dont have a tendency to accumulate fat again and reach the body set point.