CICO just restates the problem without offering much in the way of causality when it comes to obesity. Worse, it assumes you have control over calories in and calories out. You can never know your calories in to a degree of precision because not only is isocaloric not isometabolic (Asclepius' uncertainty principle - you cannot know the fate of a calorie of food), the bioavailability of food be affected my factors such as how well it is cooked and which foods we combine when we eat.
We then have hormonal factors (affected by such things as sleep, light quality and frequency, stress), levels of BAT, periodicity of consumption (ADF and IF can have a different impact on obesity than the consumption of the same number of calories on a regular basis). Hell I've not even mentioned epigenetics (most of us in the West can ignore genetics). Oh, don't forget (chronic) inflammation, mitochondria and gut flora...
On the hormonal side, we see plenty of examples of a condition where increased hormonal activity drives appetite and growth - pregnancy and puberty being two such examples. So why not obesity? That is to say why dismiss obesity as a condition which makes us eat more?
Puberty illustrates another interesting point; teenagers are known for eating loads and doing bugger-all apart from lazing about the house - and yet they are historically skinny. It is almost as if their bodies are eating loads to fuel growth and reducing energy expenditure (through enforced lethargy), to reduce calories out! And despite eating more and doing less, they are skinny.
In terms of obesity and dieting (I use the term 'dieting' in its popular form here), a reduction in 'calories in' or an increase in 'calories out' is assumed to leave all other factors constant. The thought is never entertained that by eating less, the body's control systems may well make you move less to compensate. Similarly the idea seems to be lost on some that my doing more exercise, appetite may be stimulated.
With regard to this last point, you'll find plenty of people who recommend the ELDM model and yet are unable to explain the paradox illustrated here.
Sure some people lose weight on each and every diet, but this is not necessarily sustainable weight loss. Some folk EL and DM but the short-term results are reversed in time. Why should willpower give in when a goal is realised? Why does dieting for so many people feature a return ticket to a place of absolute fucking misery?
Where was I? Ah yes, this post was not intended to be a rant, rather a heads-up to UK residents. BBC2s Horizon has a program airing this week called "The Truth About Exercise",
- "Like many, Michael Mosley want to get fitter and healthier but can't face hours on the treadmill or trips to the gym. Help may be at hand.
He uncovers the surprising new research which suggests many of us could benefit from just three minutes of high intensity exercise a week.
He discovers the hidden power of simple activities like walking and fidgeting, and finds out why some of us don't respond to exercise at all/
Using himself as a guinea pig, Michael uncovers the surprising new research about exercise, that has the power to make us all live longer and healthier lives."
A second clip can be seen here. In this clip (Dr) Mosely outlines new research favouring a 'less is more' approach in pursuit of health.
Not sure how the full program will pan out but if, as is suggested above, they uncover some of the nuances of the relationship between exercise, fitness, health (and by association weight loss), then it should be quite good.
Of course if Michael Mosley read this blog then he'd have been aware of all this stuff back in 2008. I look forwards to him changing his diet to align with mine sometime around 2016. ;)