When it comes to body change, there’s no topic more polarizing than “calories in vs. calories out.” Some argue it’s the be-all and end-all of weight loss. Others say it’s oversimplified and misguided. In this article, we explore every angle of the debate from “eat less, move more,” to hormonal issues, to diets that offer a “metabolic advantage.” In doing so, we answer—once and for all—how important calories in vs. calories out really is, and discuss what it means.
CICO is an easy way of saying:
When you take in more energy than you burn, you gain weight.
When you take in less energy than you burn, you lose weight.
This is a fundamental concept in body weight regulation, and about as close to scientific fact as we can get. Then why is CICO the source of so much disagreement? It’s all about the extremes. At one end of the debate there’s a group who believes CICO is straightforward. If you aren’t losing weight, the reason is simple: You’re either eating too many calories, or not moving enough, or both. Just eat less and move more.
At the other end is a group who believes CICO is broken (or even a complete myth). These critics say it doesn’t account for hormone imbalances, insulin resistance, polycystic ovary syndrome (PCOS), and other health problems that affect metabolism. They often claim certain diets and foods provide a “metabolic advantage,” helping you lose weight without worrying about CICO.
Neither viewpoint is completely wrong, but neither is completely right, either. Whether you’re a health and fitness coach tasked with helping clients manage their weight—or you’re trying to learn how to do that for yourself—adopting an extreme position on this topic is problematic; it prevents you from seeing the bigger picture.
This article will add some nuance to the debate. I’ll start by clearing up some misconceptions about CICO. And then explore several real-world examples showing how far-right or far-left views can hold folks back and rethinking common misconceptions.
Much of the CICO debate—as with many other debates—stems from misconceptions, oversimplifications, and a failure (by both sides) to find a shared understanding of concepts, so let’s start by getting everyone on the same page for a change.
CICO goes beyond food and exercise. There’s an important distinction to be made between CICO and “eat less, move more.” But people, especially some CICO advocates, tend to conflate the two. “Eat less, move more” only takes into account the calories you eat and the calories you burn through exercise and other daily movement. But CICO is really an informal way of expressing the Energy Balance Equation, which is far more involved.
The Energy Balance Equation—and therefore CICO—includes all the complex inner workings of the body, as well as the external factors that ultimately impact “calories in” and “calories out.” Imperative to this, and often overlooked, is your brain. It’s constantly monitoring and controlling CICO. Think of it as mission control, sending and receiving messages that involve your gut, hormones, organs, muscles, bones, fat cells, external stimuli (and more), to help balance “energy in” and “energy out.” It’s one hell of a complicated—and beautiful—system.
Yet the Energy Balance Equation itself looks really simple. Here it is: [Energy in] – [Energy out] = Changes in body stores. Body stores refers to all the tissues available for breakdown, such as fat, muscle, organ, and bone. I purposely haven’t used “change in body weight” here because I want to exclude water weight, which can change body weight independent of energy balance. In other words, water is a confusing, confounding variable that tricks people into thinking energy balance is broken when it’s not.
With this equation, “energy in” and “energy out” aren’t just calories from food and exercise. As you can see in
the illustration, all kinds of factors influence these two variables. When you view CICO through this lens—by zooming out for a wider perspective—you can see boiling it down to “eat less, move more” is a significant oversimplification.Sometimes directly; sometimes indirectly, but make no mistake, even when you’re not “counting calories,” CICO still applies. CICO might sound simple, but it’s not. There’s no getting around it: If you aren’t losing weight, you either need to decrease “energy in” or increase “energy out”, or both. But as you’ve already seen, that may involve far more than just managing your plate or spending more time at the gym.
To help, here are common energy balance challenges. In each case, it might be tempting to assume CICO doesn’t apply. But look a little a deeper, and you’ll see the principles of CICO are always present.
CICO Challenge #1: Underestimating calorie intake. It’s insanely easy to miscalculate how much you’re eating, as it’s usually unintentional. The most typical ways people do it:
They aren’t aware of what “a portion” of a food really is (don’t read the labels, guesstimate, etc).
They totally underestimate the portions they’re actually taking (For example, without precisely measuring “one tablespoon of peanut butter,” it might actually be two, which adds 90+ calories each time you do it)
They don’t track bites, licks, and tastes of calorie-dense foods. (For example, your kid’s leftover mac and cheese could easily add 100 calories)
They perceive a “handful” as being the same as ¼ cup (it isn’t).
They don’t record everything in the moment and forget to log it later on.
They “forget” to count foods they know are unfavorable or wish they hadn’t eaten.
Don’t believe this can be a big issue? A landmark study, and repeated follow up studies, found people often underestimate how much they eat over the course of a day, sometimes by more than 1,000 calories. I’m not bringing this research up to suggest it’s impossible to be realistic about portion sizes. But if you aren’t seeing results on a low-calorie diet, it’s worth considering that underestimation may be the problem.
CICO Challenge #2: Overeating on the weekends. Work weeks can be stressful and when Friday night rolls around, people put their guard down and let loose. (You probably can’t relate, but just try, okay?) Here’s how it goes: Let’s say a person is eating 1,500 calories a day on weekdays, which would give them an approximate 500-calorie deficit.
But on the weekends, they deviate from their plan just a little. Drinks with friends and a few slices of late night pizza on Friday An extra big lunch after their workout on Saturday Brunch (with champagne) on Sunday (“Hey, it’s breakfast and lunch, so I can eat double!)
The final tally: An extra 4,000 calories consumed between Friday night and Sunday afternoon. They’ve effectively canceled out their deficit, bumping their average daily calories to 2,071. If you have slashed your calories dramatically, but you aren’t seeing the expected results, look for the small slips. It’s like being a metabolic detective who’s following—perhaps literally—the bread crumbs.
Generally speaking, in addtion to tackling challenges like the ones discussed above, your calorie management efforts may require you to:
1. Improve the quality of what you’re eating in addition to reducing the quantity. Just by improving the quality of your calories, you may be able to eat more food with better satiety and fewer total calories consumed (example: a cup of broccoli vs a cup of potato chips).
2. Increase your daily non-exercise movement by parking the car a few blocks away from your destination, taking the stairs, and/or standing while you work
3. Tinker with the macronutrient makeup of what you eat. For example: eating more protein and fiber, or increasing vegetables and lowering fats, and similar tweaks.
4. Consider temporarily tracking your food intake—via hand portions or weighing/measuring—to ensure you’re eating what you think you’re eating (as closely as reasonably possible)
5. Experiment with the frequency and timing of your meals and snacks, based on personal preferences and appetite cues
6. Evaluate and correct nutritional deficiencies and/or food allergies and sensitivities, for more energy in everyday life and for workouts)
7. Get more high-quality sleep to better regulate appetite, hunger hormones, improve recovery, and increase metabolic output
8. Try stress resilience techniques like meditation, deep breathing, and spending time in nature
9. Trade some high-intensity exercise for lower-intensity activities, in order to aid recovery and reduce systemic stress
CICO Challenge #3: “I’ve been eating the same way forever, but suddenly I started gaining weight.” Can you guess what happened? More than likely, “energy in” or “energy out” didchange, but in a way that is subtle, unnoticeable.
The culprit(s) could be:
Slight increases in food intake, due to changes in mood, hunger, stress, or other circumstances (work, home, or social)
Unrecognized decreases in physical activity and/or exercise
An increase in the amount of energy absorbed—caused by new medication, an unknown medical condition, or a history of chronic dieting
Physiological changes that resulted in fewer calories burned during exercise and at rest
The onset of chronic pain, provoking a dramatic decrease in non-exercise activity thermogenesis (NEAT)
Significant changes to sleep quality and/or quantity, impacting metabolic output and/or food consumed
In all of these cases, CICO is still valid. Energy balance just shifted in subtle ways, due to lifestyle and health status changes, making it hard to recognize.
CICO Challenge #4: “I can’t stop gaining weight, so it must be my hormones.”
Hormones seem like a logical scapegoat for weight changes, and while they’re probably not to blame as often as people think, hormones are intricately entwined with energy balance. Even so, they don’t operate independently of energy balance.
In other words, people don’t gain weight because “hormones” directly. They gain weight because their hormones are impacting their energy balance.This often happens during menopause or when thyroid hormone levels decline. Take, for example, triiodothyronine (T3) and thyroxine (T4), two thyroid hormones that are incredibly important for metabolic function. If levels of these hormones diminish, weight gain may occur. But this doesn’t negate CICO: Your hormones are simply influencing the “energy out” portion of your energy balance.
Research suggests people with mild (10-15% of the population) to moderate hypothyroidism (2-3%) may experience a metabolic slow-down of 140 to 360 calories a day. That can be enough to lead to weight gain or make it harder to lose weight. Mild hypothyroidism can be so mild many people don’t experience a significant shift in metabolic activity, making it a non-issue.
Critical factor: your results aren’t just diet dependent. They’re behavior dependent. Maintaining a healthy body (including a healthy body weight) is about developing consistent, sustainable daily habits that help you positively impact “energy in” and “energy out.” This might be accomplished while enjoying the food, by:
Being mindful of having a balanced plate of proper protein, fiber/veggies, rational starch.
Eating until you’re 80% full
Eating slowly and mindfully
Eating more minimally processed foods (aka, fresh foods)
Getting more high quality sleep
Taking steps to reduce stress and build resilience
Kick your workouts and general movement up a notch (JUST 1 notch, not 3)
It’s about viewing CICO from 30,000 feet and figuring out what approach feels sane—and achievable—for you. Sure, that might include a plant-based or a keto diet, but it absolutely might not, too. And you know what? You can get great results either way.
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