Why just counting calories doesn't work

New research has been published that suggests the belief that “moving more and eating less” is actually wrong and the oversimplification of the “calories in-calories-out” model ignores the fact that the quality of the nutrition contained in the calories eaten is the key.

The paper, published in the AJCN argues that successful weight loss and weight maintenance is much more about WHAT you eat rather than HOW MUCH you eat.

The weight loss is directly related to our hormonal response to the food eaten and these hormonal changes are the primary driver for excess fat storage.

When high glycaemic load (GL) foods are eaten (usually refined carbohydrates that cause a rapid increase in blood sugar), the body responds via 2 hormones. Firstly, by increasing its production of insulin. This causes the body to take this raised blood sugar into its cells and convert it into fat; secondly by suppressing production of glucagon. This hormone helps to restore blood sugar levels when these drop. These 2 hormonal changes effectively prime the body for fat storage. There is a rapid rise and fall in blood sugar as a direct consequence – which then, when detected by the brain, sends a signal to the body to eat more. At the same time, the body, in its efforts to conserve the available blood sugar, will slow the metabolism.

So, instead of focusing on the energy balance model, the authors advocate a shift in focus to a carbohydrate-insulin model. If hunger can be reduced and the production of insulin controlled, then sustainable weight loss is possible. Carbohydrate has been shown to be the main macronutrient that impacts on insulin production. Lower carbohydrate diets have been shown to reduce appetite, as well as limiting the hormonal responses of insulin and glucagon. This all occurs in the absence of calorie counting or trying to eat less.

By changing our approach to diets and focusing on the quality of calories rather than the quantity, we can exert some control over the hormonal changes that drive us to eat to excess. Some recommendations include:

Eating more fibre rich foods. This delays the stomach emptying and also increases satiety. Typical foods include unrefined carbohydrates such as vegetables, beans, legumes, pulses, whole grains, nuts and seeds. Whole foods are preferable to fibre supplements.

Focus on lean protein and healthy fats. Protein and fat have little impact on blood sugar so this will remove the blood sugar spikes that drive insulin release.

Reduce consumption of Ultra-processed foods. These foods are considered to be highly palatable – usually lacking nutrients and often found in snack foods. These foods have been created in the laboratory to limit our ability to feel hunger and increase our desire to eat more. Crisps/ biscuits/ cakes and fast foods are typical examples.

Reduce sugar consumption. Excess sugar consumption has one of the biggest impacts on insulin and this quickly leads to hunger and cravings for more. If instead, you can satisfy your sweet tooth with some fruit, preferably the whole fruit rather than juice, then the presence of the fibre contained will slow down the blood sugar response. Look out for added sugar sources such as fizzy sugary drinks, sweetened cereals, cakes and pastries.

Practice more mindful eating. Paying attention to those hunger cues and asking if you really are hungry or maybe just bored or stressed. Also avoid eating whilst doing something else such as watching TV or playing on devices – all things that can distract you from focusing on what you are actually eating, and therefore may not recognise immediately that you are full.

Pay attention to your sleep. If you get less than 7-9 hours restful sleep on a regular basis this can play havoc with your hunger hormones making you more hungry for snack type food and less satisfied when eating it – thus being sleep deprived can make you consume a lot more unhealthy calories.

When you consider the serious health implications of insulin resistance, fatty liver disease and T2D and appreciate that a lower carbohydrate diet as outlined above can provide positive health outcomes, it makes sense to consider an alternative model to tackling obesity.

If you want to read more, the experts at Consulting Room really know what they're talking about and have put together some fat and weight loss FAQs just for you.

If you have more questions, you can use the fat and weight loss questions feature to talk to our panel of trained medical experts.

If you're keen to get started with any of these treatments right away then you're in luck - those clever folks also have a list of trusted, accredited fat and weight loss clinics in your area.

Many thanks to the author of this blog Dr Sam Robson who owns Temple Clinic.

Dr Sam Robson is a highly respected and experienced practitioner who qualified as a GP in 1997 and has been practising aesthetic medicine since 2004.

She has also become progressively aware of the increasing incidence of low morale and self-esteem

The repertoire of treatments provided by the clinic aims to help address many problems.

Call Dr Sam Robson on 0122 486 9997 or visit www.templeclinic.co.uk.

Why just counting calories doesn't work

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