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Weight Loss (...yes, again...)
I listen to a variety of podcasts, and I generally do what I can to avoid listening to ads along the way, even if that's just manually skipping ahead through them. But occasionally, my hands are busy with something else, and I just have to deal. In any event, last week, I heard an ad for GOLO, a weight-loss program.
I'm not at 'current episode' on all of my podcasts; I'm listening to back catalog for some of them. I didn't think to go check the date on it, and I don't even remember which podcast it was in at this point, so I don't know if it was a few years old or brand new, but at whatever time it was, they were touting it as a "new approach". Forbes' review of GOLO says 2023 on it, so presumably it's pretty recent.
I was curious about what the Kids These Days are doing, and you may have seen me here before talking about weight loss, so I decided to check it out. I was sooooo ready to hate it. After checking it out, though, in some sense, it actually pleases me a fair amount. In another sense, it illustrates quite well a phenomenon I've been seeing in terms of our society's collective psychology about the topic.
What's GOLO about? From their website... insulin resistance! Muscle loss! These are the bad buzzwords. Metabolic efficiency! Immunity Health! Hormone Balance! These are the good buzzwords. Plus, they have a magic supplement! It's easy! Just take one capsule with each meal. It's in a paragraph that starts with "The Science Behind GOLO", in bold and everything. The Science (TM) is right there! They even shit on CICO, helpfully pointing out in all caps:
Let's dive in, see what's really going on. Obvious first place to start is their supplement; what's in it? 7 plant extracts and 3 minerals, of which, best as I can tell, chromium is the star of their show. Of course, best as science can tell, there is just the barest degree of plausibility, and Examine concludes by pointing out:
Ok, so if their magic suppliment isn't exactly Ozempic, what do they have going on? Gotta dig into 'More Information' on their site.... then be careful! Don't fall into the trap of clicking on any of the distractions, even the one that promises to tell you what their 'GOLO For Life Plan' is. Gotta go to the FAQ. That's where you've gotta dig down into the question about what the GOLO For Life Plan is. It helpfully states:
I tried to be helpful and cross out all the noise that isn't relevant for us at this point. What is the real key to a fancy new diet for weight loss that has all the buzzwords that people use when they say that CICO is garbage? It was CICO all along! There are more telltale signs that this is just a recycling of what we've known for a long time. 1300-1800 is a pretty wide range, so what's going on? Two more items further down in the FAQ, under How is the GOLO For Life Plan Personalized?, we see:
That Forbes article fills in some more details:
The government of Canada has helpfully published basically exactly this sort of thing on their website for years. We've known how to do this for years. Weknowdis. Moreover, the real, actual science has confirmed for decades that to a pretty darn good level of approximation, 500cal/day from your TDEE is right about a 1lb/wk weight loss/gain. Weknowdis.
Forbes says, "Programs range from 30 to 90 days," but I can't find solid details on the GOLO website. Most of the examples are people who did stuff for 6mo-1yr. Best I can tell, they're basically just selling the supplement, and then I guess giving away the meal planning to put you in the right calorie range. So, for a bit, with the Forbes wording, I was wondering if they were actually going to have some trick to try to get you to do it for 1-3mo, then 'cycle off', but try to figure out how to get you to just go back to maintenance caloric intake, then say that you should start another 1-3mo cycle. Maybe that's buried somewhere in the planning tool they're giving away with every purchase of the supplement. Final thing to point out, which I couldn't really find in detail on the GOLO site, Forbes says:
In the end, what have they done here? It actually almost makes me proud of capitalism. They've found a way to package and monetize the bog standard, traditional advice for losing weight. You could just listen to the CICO people, the honest doctors, the fitness people, etc., who tell you the same basic advice. Stop eating total crap like piles of dessert all the time. Stop drinking big gulps of straight sugar calories, no matter whether they're soda, juice, or whatever other trendy beverage is happening right now. Eat at about a 500cal/day deficit to shoot for 1lb/wk of weight loss, eat regular foods, and maybe if you're feeling physical/psychological effects after getting somewhat deep into a cut, go back to maintenance for a bit, and then start again.
But the packaging. Ohhhh the packaging! Insulin resistance! Metabolic efficiency! Immunity Health! Hormone Balance! CICO SUCKS! They do what they can to try to meet people where they are. To try to get them used to the idea that they're shooting for about a pound a week, so it'll be longer than other people promise (though, of course, they say 1-2lb/wk, just to get your brain to think it could be twice as fast). And of course, the cherry on top, a supplement that probably doesn't really do anything is the mechanism by which they monetize. Hell, after people lose the weight, I bet the GOLO For Life thing basically steers them toward how to stay at maintenance for the rest of time... but you probably better keep buying/taking their supplement, just to make sure you don't ruin all your gainz! It's a thing of sheer beauty, designed to bob and weave around all the CICO bashers who are going to scream from the rooftops that CICO doesn't work and trash your weight loss program if it even hints at the idea that CICO is what's going on rather than repeating the buzzwords and bowing at the god of, "It's not your fault, it's... check cue card... insulin resistance!"
In the end, I can't help but love it. Could you have listened to me tell you basically all the same underlying facts? Sure. Could you find a plethora of communities or official government public health documents that outline how you can do all this same stuff, but for free? Yup. But man, we're too dry in the delivery, and we tend to be abrasive to the folks who want to believe that there is some other magic going on in the world. I can't help but think of how Matt Levine might put it. The market wants the bog standard advice that works and that is backed by science, but it also doesn't want it to sound like that. It wants to hear some buzzwords, platitudes, shitting on CICO, and having a magic supplement. That's an arbitrage opportunity, and GOLO seems to have filled it.
EDIT: Sigh, I tried so hard to get the strikethroughs to work inside the bulletpoints. It displays correctly in the comment preview (and still displays correctly in the preview as I'm editing). But it's broken in the actual comment. @ZorbaTHut Help?
When it comes to CICO, the problem is that reducing your CI reduces your CO.
When an obese person reduces their caloric intake from 3000->2500 calories a day, their body reacts to this perceived deficit with increasing hunger levels and lower energy. If they burned 3000/day before, now they are only burning 2700/day as their activity levels falls to match the lower energy. Weight loss is minimal, hunger is high, and energy is low.
CICO can still work if you strictly monitor weight loss and caloric intake, but it's not easy, and it will revert as soon as the person goes back to eating naturally.
For myself, I've been doing keto for a few weeks now and I'd rate it as highly effective. I've lost a decent amount of weight and hunger levels are very low. I sometimes feel physically very full even without eating a large amount of food. The biggest downside seems to be moderately lower energy levels, which I've countered with targeted carb consumption (10 grams) before strenuous workouts.
Where are you getting these numbers? Are they coming from a table/calculator based on published scientific data? Did you, like, plug a different activity level into the equations that were in the link I gave to the Canadian government's site? Are you going to some review paper that details this effect? For example, this meta-analysis of the effect of exercise programs on resting metabolic rate says that mayyybe the delta there is like 70-100cal/day. Where are you getting 300cal/day just from diet changes, and what are your assumptions?
The numbers were meant as an illustration, and would vary highly by individuals. For some people, the difference is much more stark.
In the linked article, morbidly obese people who lost a lot of weight were burning 450-800 calories fewer per day than a similar person of their weight, age, and gender.
This seems loosely correlated to my claim that reducing CI reduces CO. For one, it is related to exercise programs not dieting. Secondly, it deals with base metabolic rate and which is part of, but not the entire, cause of reduction in calories burned due to diet-based lethargy.
But you are correct. I am unsure of the exact figures. My own experience with CICO-based dieting matches that of the general population. It works, but it is possible only with strict calories counting. Hunger and low energy are one's constant companions, making the effort not worth the cost. In a calorie counting diet, people generally revert back to unhealthy habits as soon as they stop strictly counting calories.
According to this, that Biggest Loser study was an extreme outlier, and numerous other studies have found either no effect or a much smaller effect.
I think a big tripping point is what you're counting as energy expenditure. For instance, the piece you linked cites this meta-analysis and claims it "found no penalty". However, if you look at the actual meta-analysis, one of the inclusion criteria is
So, it is looking at various measures of resting metabolic expenditure. In other words, it is explicitly excluding studies of non exercise activity thermogenesis (NEET) - that is, it is excluding "the energy expended for everything we do that is not sleeping, eating or sports-like exercise" - this is summarized as "fidgeting"
When I skim the other links the article uses to prove that there is no effect, I see the same issues. The one study they cite without this issue found significant declines in energy expenditure.
Other studies also find large changes in energy expenditure and suggest (1) the degree of change varies significantly from person to person and (2) is largely genetic. For instance, in this study, researchers established a neutral level of calories needed by each member of a collection of identical twins, added 1000 kcal to that, and then fed that to the twins over 100 days while they lived mostly sedentary lives under 24-hour supervision. Before and after, they measured energy expenditure on the neutral diet. Based on a naive CICO model, each of these twins should have gained ~12 pounds. Instead (see Figure 1), they gained between 4 and 13 pounds.
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