One of my patients and I continually have discussions regarding the myth of weight control boiling down to calories in versus calories out. In other words, expend more calories than you take in and you lose weight. Consume more calories than you burn and you gain weight. Because he has heard this presented as fact for so long from a wide variety of sources, accepting this as a fallacy is difficult for him.
My lifestyle changed dramatically with last March’s surgery. No racing up mountains during my recovery. No running at all, actually. No swimming either. No weight lifting for several months. Certainly no tennis, not even at a recreational level. My high volume of intense exercise was initially replaced with walking, months and months of just walking. Due to a lack of vigorous exercise, my cardiovascular fitness is deplorable compared to what it was not too long ago.
My eating has changed as well. Since I could tolerate more food in my stomach during a walk than, say, a run, the size of my breakfasts increased. While my food choices are almost exclusively vegetarian for ethical reasons, I reincorporated chicken and beef during the first few months of my recovery to ensure that I provided my healing body with the protein that it needed. Since my surgeon reminded me of the importance of calcium in promoting fusion in the bone grafts, I significantly increased my dairy intake, mainly in the form of ice cream.
What I did not do is weigh myself, track my weight, monitor my calories, attempt to quantify my caloric expenditure, or buy into any sort of nonsense about my weight or fitness level saying anything about my value as a person or my competence as a dietitian.
With all of the radical changes in my lifestyle, do you know how much my weight changed from before the surgery until now? Exactly zero pounds. According to the weights that my doctors recorded at my appointments, I am the same weight now as I was before the operation 10 months ago.
If one pound of body fat is worth 3,500 calories (I am not saying this assertion is accurate, but it represents another myth that continues to float around.) and the calories-in-calories-out theory is true, I would have had to have balanced my energy intake and expenditure within less than 12 calories per day on average for the last 305 days. That, ladies and gentlemen, is impossible.
Yet the calories-in-calories-out ridiculousness is not widely recognized for what it is. Recently, someone posted on Facebook a printout that her doctor gave her containing weight loss advice. “Change your diet,” it says. “Eat 500 fewer calories a day. This can lead to weight loss of one pound per week.”
In nutrition, sometimes a little bit of knowledge is worse than no knowledge at all. The notion that calories in versus calories out dictates weight is nutrition 101, but what they tell you in nutrition 102 is that it is not really true. It has some merit as a general concept, but it should never be taken literally, as weight regulation is vastly more complex than that.
During my recovery, I have moved my body in the ways that have felt most comfortable at the various stages of my healing and consumed the foods that my body seems to be asking for in the quantities that are satisfying. When I have missed the mark by overeating, for example, I do not feel guilty or beat myself up; rather, I look at the episodes as learning experiences to figure out what happened and what I can do differently in the future.
Because of these behaviors, plus genetics and other factors that are out of my hands, my weight has happened to stay the same. If it had changed, would I have cared? Sorry, I know this might be hard to believe in the context of our weight-obsessed culture, but my interest is elsewhere.
My plan is to make my comeback to competitive racing at this June’s Mount Washington road race. This is where my attention is focused. I have five months to ramp up from virtually no running to racing 7.6 miles up the highest mountain in the northeast. Can I do it? We’ll see. But I can tell you this: I am excited and looking forward to the challenge.