Count On It

Ample evidence exists to suggest that calorie counting as a means of weight loss is limited in its ability to drive sustained success for those looking to achieve health. Firstly, the idea that one should lose weight ought to be determined by a doctor, given that many suffer from body dysmorphia and might be a normal weight for their height. This consideration aside, the reason calorie counting is not a strong strategy is that calorie needs fluctuate with physical and even mental activity. I can recall in medical school, some of the most demanding weeks of classroom learning had me eating much more than usual. Working out can create calorie demands that exceed the amount of intake and if you are restrictive this will lead to craving and make restraint difficult. Meals should be healthy and consist of plenty of caloric and nutrient density. This will provide satiety and give the energy required for sustained repair and function.
Another reason this method of weight loss is flawed is that research strongly suggests that much of our food behavior is dictated by our gut microbiota. Conventionally raised cows are not necessarily provided antibiotics so much as to protect them from disease, but rather because long ago it was observed in mice that low dose antibiotics led to obesity. Livestock were then given the same treatment to provide a fattier product that went for more on the market. Microorganisms that live in your intestines can also dictate what it is you are craving. If they have had a lifetime of eating refined carbohydrates and sugars of various types, when starved they can die off and release endotoxins found in their membranes that lead to inflammation. That inflammation is then resolved with the consumption of these foods and therefore controls much of what looks appetizing to us. In contrast, if healthy organisms exist in your gut and are fed things such as fiber rich foods, those indigestible sugars are converted to short-chain fatty acids that can provide the energy basis for intestinal healing. There exist contrasting opinions about what exactly makes up a healthy microbiota, but nonetheless it is agreed upon that the importance of these organisms as they relate to weight is unquestionable.
Healthy controls in studies do demonstrate a very different microbiota profile than that of their obese counterparts and interventions like a gastric bypass surgery has shown to alter microbiomes in those treated individuals to resemble the healthy controls. My usual recommendation is not to go the route of surgical intervention but rather take corrective measures dietarily using probiotic foods and those rich in fiber to contribute to a healthy balance of organisms right for you. The opposite is removing those harmful substances such as antibiotics and preservatives that could be disruptive. Consult a physician when you are considering a procedure such as a colonoscopy which involves a heavy dose of medications for bowl preparation that I have seen in my patients lead to uncontrollable weight loss. This intervention, which is still very helpful at times and even lifesaving, can potentially be avoided using genetic screening if you are not at high risk of colon cancer. Despite the current state of our overwhelming medical paradigm, it is my goal to do what is possible to prevent the further overuse of antibiotics and that is why the study of microbiology is so paramount to my success in doing so. Consulting a naturopathic physician such as myself might be the first step to preventing harm and potentially restoring damage done to the gut from previous medical treatments.
Gupta A, Osadchiy V, Mayer EA. Brain-gut-microbiome interactions in obesity and food addiction. Nat Rev Gastroenterol Hepatol. 2020 Nov;17(11):655-672. doi: 10.1038/s41575-020-0341-5. Epub 2020 Aug 27. PMID: 32855515; PMCID: PMC7841622.