What are Calories Part 2

So last time, in the guise of addressing the emails of an Internet crazy person and his assertion (so far as I can tell) that since calories are not an actual physical thing, the calorie model of body weight is not valid.  I addressed a ton of different issues related to the concepts of calories.  This included what they are, how they are measured, some serious pedantry regarding vocabulary and what they ultimately represent.  The overall summary of what I wrote there is that while it is true that calories are not a physical entity (i.e. I can’t hand you a bottle of calories), they are valid in that they represent a defined measurable quantity (the generation of heat) related to how something that is real (i.e. food or nutrients) is metabolized within the body.

Basically calories, like other concepts such as watts or horsepower, are a semantic proxy for something that does exist.  And while our language is imprecise it is the height of semantic stupidity to dismiss the concept based on that imprecise language.  No, we do not “eat” calories, we eat food.  Said food being metabolized in such a way as to produce heat which can be measured and defined in terms of calories.

So what does this all mean in terms of the calorie or energy balance model of bodyweight?  Well, that’s what I want to talk about today.  Some of this will tread the same ground as my article on Energy Balance and I’ll try to only summarize some of those concepts since the details can be found there.

Calorie/Energy Balance: Part 1

At the most basic level, we often talk about calorie balance which represents the difference between calorie intake (from food) and calorie expenditure (from a variety of components such as Resting Metabolic Rate, Activity and others).  If calorie intake exceeds calorie expenditure, we gain weight/fat (I’ll explain this momentarily).  If calorie intake matches calorie expenditure, no change occurs.  If calorie intake is lower than calorie expenditure we lose weight.   More technically we state that

Calorie Expenditure – Calorie Intake = The Change in the Energy Stored in the Body

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What are Calories Part 1

If I haven’t been as consistent with updates beyond endless podcasts, it’s because I sustained a major lower body injury (broken fibula and two torn ligaments) about 12 weeks ago and, let’s just say, my head hasn’t quite been in it.   I’ll write about that eventually to detail what happened and my recover but for today, I want to do a piece that I’ve wanted to write for a while.

Now, there are a lot of crazy people on the Internet.  Sometimes I have even been one of them.  But this article is about a different kind of crazy person.  I won’t name him since I don’t believe in giving crazy publicity or even acknowledging them by name but he sends myself and others in the field relentless numbers of all caps insane emails.  He’s a complete nutjob.

In the most general sense, he’s one of the deniers of energy balance and Calories In Calories Out (CICO) as it pertains to body weight and body composition.  It’s the typical bs although his newest insanity is how calories not an actual thing that exists and, by some sort of extension I guess, that the calorie model of changes in body weight is incorrect for that reason.  That is, since calories doesn’t exist, they can’t explain the changes that occur in terms of bodyweight or body fat.

Now, in one sense, this crazy person is actually correct: calories are not a thing in the sense of physically existing in this universe.   I can’t put a calorie in your hand, I can’t feed you a plate of calories per se (and that will make sense in a moment), I cannot show you a physical object that is a calorie.  I could do those things with, say, a quarter or an apple.  I can’t do it with calories.

But does that make him right about the rest of it?  Would I be writing this article if it did?

What are Calories: Part 1

This crazy person’s mistake, well one of them anyhow, is in assuming that anyone has ever claimed that a calorie is a physical object in the first place.  It’s just a weird strawman that exists only in his mind.    And that is because a calorie isn’t a physical object. Rather it’s a defined measurement.  Specifically it is a measurement of heat.  Even more specifically:

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Does the EC Stack Stop Working

Last week, I answered a Q&A about ephedrine and caffeine (the EC stack) and how long it can be used.  And in that piece I made a throwaway/unexplained statement of:

I do mean that this is unusual in that most drugs lose, or at least appear to lose, their effect over time (it’s a little more complicated than this but I’ll save my explanation of this statement for next week or something).

I also presented data showing that this is actually absolutely not the case, that EC clearly not only continues working in the long-term but, for some reason, becomes more effective over time.  And this goes against what is most commonly believed about not only EC (with claims that it stops working, usually based on the fact that the side effects are no longer felt) but with almost all dieting drugs (including the big pharmaceutical ones).   This is true whether they work through metabolic effects (i.e. by increasing energy expenditure) or decreasing appetite (as most pharmaceutical drugs to date have done).  Most seem to generate about a 10% weight loss and that’s it.  They “stop working”.  Or do they?

And the answer, in my opinion is no.  Rather, the perceived loss of effect is for a different reason.  And that reason is how the body adapts to dieting.  We know that with dieting/fat loss, there are adaptations that occur in all aspects of the energy balance equation.    There is an increase in hunger and appetite along with increased enjoyment of highly rewarding foods (highly palatable, high-calorie, high-fat, high-sugar foods).  There is even an increased noticing and attention to those foods that occurs.

All aspects of energy expenditure go down as well.  Resting metabolic rate (RMR) drops due to both the loss of bodyweight and an adaptive component.  The thermic effect of food (TEF) goes down due to less food being eaten but there doesn’t appear to be any other major effect.  The thermic effect of activity (TEA) goes down due to the reduction in bodyweight along with an increase in efficiency within skeletal muscle (the body burns less calories at any given energy expenditure); this can be compensated for by increasing the volume or intensity of exercise.  Finally there is Non-Exercise Activity Thermogenesis (NEAT) with limited work showing that it decreases on a diet.

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Antidepressants and Weight Gain

Question: Why do antidepressants cause weight gain?  Is there any way to lose weight on them?

Answer: Apparently, since talking fairly openly about my own mental issues I’ve sort of become the go-to guy on this topic for many people.  Which is only potentially overwhelmed by the influx of questions or Facebook PM’s I get about women’s periods right now.

Let me say up front that neuropsychiatry and all of this is not my primary field nor area of expertise and absolutely don’t claim that it is.    At the same time, the neurochemistry of eating behavior is a long time interest and there is certainly crossover between the topics which is why I feel comfortable enough writing about this.  Anyhow.

I couldn’t really answer the first question simply as asked since some anti-depressants are just as likely to cause weight loss as weight gain.  Much of it depends on the type of medication you’re talking about and the context as always.  So let me look at a few different types of medications and how they might or might not impact on this.

I’m also not going to try to be comprehensive and get into all of the other potential drugs such as bipolar treatment drugs such as lamictal (what I’m on), depakote, etc.  This is just about anti-depressants and I’ve probably missed a class of them somehow.

Serotonin Based Antidepressants and Weight

I don’t claim to know the full history of antidepressant medications but I believe that serotonin based drugs were one of them. Serotonin is one of three primary neurochemicals in the brain and is involved in things like mood, eating, hunger and especially carbohydrate cravings.  They can work through different mechanisms but a common one is the specific serotonin-reuptake inhibitor or SSRI.  Prozac, Celexa, Lexapro and others are a few examples.

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Cold Exposure and Calorie Burning – Q&A

Question: Hello Lyle, I have came across a suggestion that if you spend most time of your day in a cold room, your body expends more energy as heat because it tries to keep a stable body temperature. It makes a sense to me. I would like to ask you whether is that true and if its, how big is the difference? It could be very small or maybe 100-200 kcals a day. Thanks you for your help.

Answer: The short answer is yes-ish but there are a few caveats; as usual I’ll trudge (hopefully briefly) through some of the physiology.  The basic idea is that, by being exposed to cold, the body has to burn calories to generate heat.  And there is truth to that.  Some of this is due to shivering but there is also the whole brown/beige/brite adipose tissue thing that may be at play here.

Many readers may remember a lot of interest in brown adipose tissue (BAT) a bunch of years ago.  BAT was found in animals originally and exists, roughly, to burn energy to make heat.  In contrast to normal white adipose tissue which is predominantly stored triglyceride with very few mitochondria (the powerhouse of the cell), BAT had a lot of mitochondria but not a lot of stored fat.  It existed to burn fat, generating heat.

BAT and Beta-3 Agonists

There was a huge amount of interest, drugs called beta-3 agonists (which worked amazingly in rats and mice) were developed and almost immediately crapped out.  They had minimal effect in humans and any effect was short-lived.  So they were abandoned by pharmaceutical companies.  Remember this when you see some supplement company is pushing a beta-3 agonist; if a multi-billion dollar pharm company can’t figure this out, neither can the supplement pushers.  Obesity treatment is worth billions and pharm companies stop researching dead end drugs.

And it looked like the reason had to do with the fact that adult humans didn’t have much BAT.  Babies (who thermoregulate poorly) had it, a certain type of tumor (a pheochromacytoma) had it and folks exposed to chronic cold (Oh I’m a lumberjack and I’m ok) had more of it.  But most adult humans didn’t and researchers sort of gave up on it.

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