Why Some People Are Fat and Others are Thin

They eat more calories than they expend.

That’s the simple answer.

Body Fat Images

Learn why some people gain more body fat than others, and what you can do to be leaner.
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However, as many people have mentioned, there are many factors that influence how much someone eats and how many calories they burn.

In this article, we’ll take a look at what makes some people gain fat and others stay lean. Then we’ll look at which of these factors you should worry about.

Too much eating — not enough movement.

When people eat too many calories relative to their energy expenditure — they gain weight.

When they eat fewer calories than they burn — they lose weight.

Today, we’re going to look at the main variables that affect how much you eat and how many calories you expend.

This won’t be an all encompassing list, but it will give you a basic idea of the different factors that affect cause some people to carry more body fat than others.

High set point.

Your “set point” is a range of body fatness that your body tries to maintain over a period of time.1

When you eat more calories than you need to maintain this level of body fat, your body makes changes to keep you from gaining weight.

Your body decreases appetite and sometimes increases how much you move to help burn the extra calories.

When you eat fewer calories than your body needs to maintain this level of body fat, your body makes changes to keep you from losing weight. It increases your hunger levels and decreases your motivation to exercise.

Both your initial set point and your body’s response to changes in calorie intake can be quite different from other people.

There is a huge variation in how people respond to overeating and under-eating. Some people gain weight almost exactly in proportion to how much they over-eat.2-4 They also tend to have a harder time losing this weight.

Others barely gain any fat despite massively over-consuming calories.5 These people also tend to easily lose the weight they do gain.

With the right choices you can lower your set point over time. One of the most effective ways of doing this is by making smart food choices. Unfortunately, a lot of people don’t.

Poor food choices.

People often assume they can eat less and lose weight while eating tons of junk. They’re right. But they usually have trouble sticking to this kind of diet in the long-term.

There’s nothing wrong with small indulgences, but you probably won’t be able to adhere to a diet that’s based around Ho-Ho’s and Coke. You’ll get hungry, potentially develop nutrient deficiencies, and may also not consume enough protein to help maintain muscle mass.6-9

My homemade quadruple chocolate brownies are irresistibly delicious, but not as filling as meat and vegetables and easy to over-eat. (Like every other food, they’re also fine in moderation).

Few people actually eat like that, but they still don’t make great food choices in other ways. People often don’t eat enough protein, vegetables, fruit, or fiber — and they stay hungry.6,8,10-16 All. The. Time.

These foods are more satiating than the kinds that are typical in most industrialized countries. Eating enough protein is also important to help you maintain your muscle mass while dieting.6

Food availability also helps determine how much and what you eat. If you have lots of tasty high-calorie food available at all times, then it’s easy to overeat junk food.17,18 For instance, if you have a massive stash of Oreos in your pantry, you’re able to eat thousands of calories with little to no effort.

Whole foods like rice, chicken, or butter are still very easy to prepare and can still be a source of excess calories. If you don’t keep a lot of treats in your home, you still probably have easy access to restaurants and fast food.

Another mistake people make is that they surround themselves with a huge variety of foods. This virtually always causes them to eat more than they should.

When you have a larger variety of food choices, you eat more without realizing it.19,20 This is true for both “healthy” and “unhealthy” foods.20,21

The “quality” of your diet (whatever that means to you) doesn’t change how much weight you lose at a given calorie intake. It does influence how much you eat, and thus your ability to maintain a caloric deficit over time.

Sensitivity to food cues.

Much of your eating behavior is determined by food cues — small triggers in your environment that tell you to eat more or less.22-24 Here are some common food cues that influence how much you eat:

How fast you eat.25-27

How fast the people around you eat.28

How many people you’re eating with.29-31

How distracted you are while eating.32-34

Whether or not food is disappearing from your plate.35,36

The size and dimension of the containers you eat out of.35,37

Some people eat more in response to these food cues than others. They eat more when others eat more, they’re more easily distracted while eating, etc.

People who are able to notice and understand food cues that help them stop eating or eat less generally have an easier time maintaing a healthy weight and/or losing weight.

People who are unaware of food cues or don’t respond to them, generally have more trouble losing weight.

Low exercise levels.

Janet is a sedentary person who burns zero calories through formal exercise.

Jake is a highly trained endurance athlete who can burn around 6,000 calories in a single workout.

Obviously, Janet and Jake will need to eat very different amounts of food. Jake can also probably drop weight faster than Janet.

These are extreme examples, but how much you exercise does have a huge impact on your ability to lose weight.

People who don’t exercise are generally at a much higher risk of becoming overweight, have a harder time losing weight, and struggle more with maintaining their weight loss.38-43

People who exercise regularly tend to lose more weight and keep it off better over time. You don’t have to do much, but if you want to lose weight, you should  do some moderate exercise on a regular basis.

Low daily movement levels.

Non-exercise activity thermogenesis, aka “NEAT,” represents all of the calories you burn from daily movements that don’t count as formal exercise.44

Some people have much higher levels of NEAT than others. They also tend to increase NEAT when overeating more than other people, which helps them burn off the extra calories.44-46

Small movements like standing and fidgeting can add up throughout the day, sometimes to almost 1,000 calories.5 People with high levels of NEAT have a much easier time not gaining weight and losing weight.

Low levels of self control.

Some people don’t have as much self control, or willpower, as others and aren’t as good at controlling their impulses.

When you consider that you make around 200 food related decisions per day,47 this is an obvious problem.

The desire to eat is considered the most common one you experience, making up around 28% of your daily urges.48 Most people act on these urges about half of the time.49

People who are overweight often act more impulsively and don’t control their eating and exercise behaviors as well as lean people, and have a harder time losing weight.50-52

  • They eat the second they get a small hunger craving.
  • They eat because food is available, not because they need it.
  • They eat when they see a fast food restaurant, even if they aren’t hungry.
  • When they eat, they often lose track of their food intake and eat far more than they know they should — they have greater dietary “disinhibition.”23
  • They aren’t good at motivating themselves to consistently exercise, or exercise very hard.
  • They don’t stick to diets in the long-term. 

Interestingly, people who are told they lack willpower when they really don’t give up on hard tasks sooner.53

Let’s say you have someone with a lower than normal level of self control. They overeat on a few occasions, and maybe gain some fat. Then they get angry at themselves and start to believe they’re “weak-willed.” This mindset further decreases their willpower, and they’re more likely to lose control in the future.

Their self-doubt becomes a kind of self-fulfilling prophecy.

Your ability to control your behaviors makes a huge impact on your ability to maintain a healthy weight. It will be easier for some, and harder for others, but it’s important for everyone.

Low or nonexistent awareness of calorie, exercise, and body fat levels.

Most people have no idea how much they eat. They don’t read food labels or know how many calories are in different foods.54-84 85-103 They forget how much they ate even minutes after a meal.37

Others simply have no idea how much total food volume they eat. If you asked them to remember how much they ate the previous day, they’d probably underestimate their food intake by at least 25%.

Becoming more aware of your weight, calorie intake, and exercise levels can help you lose weight.

Becoming more aware of your weight, calorie intake, and exercise levels can help you lose weight.
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People also usually assume they’re exercising far more than they really are, and that they’re burning more calories during exercise.104

You’re unlikely to make a change unless you’re aware of a reason to do so. If you don’t notice (or ignore) the fact that you’re overweight or not as lean as you’d like, you won’t take action to correct the problem.

This is as true for super lean people as it is for those just trying to be healthy. Even bodybuilders and athletes often lose track of their food intake and body fat levels when they’re not preparing for a specific event, and in some cases gain a lot of fat without noticing. Others have a hard time not losing weight for the same reasons.

Simple behaviors that make you more aware of your food intake, exercise levels, and body fat percentage can have a massive impact on your ability to maintain a healthy weight or lose fat.105,106

Keeping a food and/or exercise journal can sometimes double the amount of weight people lose in free-living conditions.107 Weighing yourself is also important to help you stay aware of how your eating and exercise behaviors influence your body fat levels.105

Lack of responsibility.

Many people blame their overweight or obesity on genetics, slow metabolisms, food companies, lack of education, etc.

In some cases, people do have lower metabolic rates than others. Some people are genetically inclined toward obesity while others are not. Some people grow up in households where they didn’t learn good eating behaviors.

However, these people are overlooking the fact that it’s their body, and thus their responsibility to take care of it.

Maybe you’re at a handicap because you have less awesome genes or didn’t learn to cook when you were young. It might be harder for you to become and stay lean than someone else, but that’s life.

No one is forcing people to eat enough calories to become overweight. They’re the ones lifting the fork, and it’s their job to take responsibility of their behaviors and make positive changes to deal with their problems.

Being lean is not a right — it’s a privilege you earn by working for it.

Misplaced priorities.

People who are thin generally make it a priority to be so.

People like athletes, models, and bodybuilders make diet and exercise a huge priority, because being lean is part of their job. They work hard and (usually) get awesome results.

If you want to get leaner, and what you’re doing now isn’t working, then you may need to place a greater emphasis on behaviors that will help you lose fat.

You can’t create more time. You can make time for what’s important to you.

Here are a few examples:

  1. Taking time to count calories and/or weigh your food, even for a little while.
  2. Making time to eat slowly, so you actually appreciate your food.
  3. Waking up earlier to work out.
  4. Checking Facebook less often, watching less T.V., and reading fewer blogs so you have more time to prepare meals and exercise.
  5. Taking the time to educate yourself about fat loss and body weight regulation by reading clear and well-referenced articles (like this one :) ).
  6. Learning to be more assertive with your boss about your efforts to get home on time so you can exercise or eat a meal with your family.108
  7. Weighing yourself every morning.

In other cases people are motivated to lose weight. They just focus on the wrong things like supplements, avoiding certain foods, toxins, etc. To get lean, you need to prioritize behaviors that will help you lose fat — not just action in general.

Hormone levels and sensitivity.

People with higher leptin and insulin sensitivity are generally going to have an easier time losing weight and maintaing a healthy weight.109 Other hormones like thyroid, testosterone, and estrogen also play a role.

The levels of these hormones can vary a lot between individuals, as can someone’s sensitivity to these hormones. You can also improve your hormone levels and sensitivity with diet, exercise, and weight loss, and poor leptin and insulin sensitivity are largely the result, not the cause, of fat gain.110-116

Genetic differences.

“…genes don’t determine a person’s absolute level of body fatness, but they do determine a person’s degree of susceptibility to a fattening environment.”

- Stephan Guyenet.

Everything you’ve learned about in this article is influenced by genetics.

Some people get a combination of genes that predisposes them to gain fat, while others get a set of genes that helps them stay lean.117

Most data indicates that genetics can explain about 30-70% of the variance in someone’s susceptibility to obesity.118

In an environment where calories and food variety are scarce and you have to work to eat, even people with “fat” genes are generally going to stay lean. Maybe not “shredded,” but healthy.37

If you have poor or good genetics, that doesn’t mean you are destined to be fat or stay lean. It means it might be harder or easier under certain conditions. You still have to create a caloric deficit to lose weight, and it’s still your responsibility to control your weight.

What you can do to be lean.

Based on the factors you just learned about, here are some changes you can make today to start getting leaner.

1. Make better food choices.

If you’re not as lean as you want to be, start eating more satiating foods. Eat enough protein, fruit, vegetables, and fiber. Get at least 80% of your calories from whole, minimally processed foods, and the rest from whatever you want.

2. Become more aware of your eating habits.

Pay attention to how much you’ve eaten throughout a meal. Eat at your own pace. Experiment with eating out of smaller bowls, using smaller utensils, and serving smaller portions.

3. Weigh yourself.

At least once a week, preferably more often. Record your weight so you can track your progress over time. If it goes in a direction you don’t want — make some changes.

4. Count calories.

Even if you only do it for a week or two. This gives you a much better understanding of what foods are contributing to your calorie intake, and where you may need to cut back. Even if you aren’t deliberately restricting calories, recording your food intake generally helps people eat less.

5. Exercise more.

Find a sport or activity you like, and start doing it consistently. It doesn’t matter what you do — just do something. Start small with a few workouts per week at a low intensity, and increase it gradually from there.

6. Move more throughout the day.

  • Stand more. 
  • Sit less.
  • Walk as much as possible.
  • Fidget or bounce your leg while you’re sitting.
  • Take the stairs.

Move as much as possible throughout the day, even if it seems pointless.

7. Practice increasing your willpower.

You can increase your levels of self control with practice.119,120 Start by making small changes to your diet and exercise program. Instead of eating 5 slices of pizza, eat 4. Run 25 minutes instead of 20. Do 20 sets instead of 15.

Challenge yourself a little over time instead of breaking yourself with unreasonable tasks.

8. Take responsibility for your behaviors.

It’s your body. If you want to change it, you need to make the right changes. You’re the person feeding yourself and exercising.

9. Make diet and exercise a priority.

If you’re using an effective weight loss strategy, you’ll get out what you put in. If you want to be leaner, put a greater emphasis on behaviors that will help you achieve that.

What other factors do you think contribute to fat gain? What other tips do you have to help people lose fat?

Share your thoughts in the comments section below.

* I didn’t really like using the term “fat” in the title, but it’s more easier to read than “overweight.”

Did you enjoy this article? Click here to get exclusive member’s-only articles and podcasts. Only want to learn how to lose fat? Click here to buy my book, Flexible Dieting.

 

References

1. Speakman JR, Levitsky DA, Allison DB, et al. Set points, settling points and some alternative models: theoretical options to understand how genes and environments combine to regulate body adiposity. Dis Model Mech. 2011;4(6):733–745. doi:10.1242/dmm.008698.

2. Klein S, Goran M. Energy metabolism in response to overfeeding in young adult men. Metab Clin Exp. 1993;42(9):1201–1205.

3. Bray GA, Smith SR, de Jonge L, et al. Effect of dietary protein content on weight gain, energy expenditure, and body composition during overeating: a randomized controlled trial. JAMA. 2012;307(1):47–55. doi:10.1001/jama.2011.1918.

4. Joosen AMCP, Westerterp KR. Energy expenditure during overfeeding. Nutr Metab (Lond). 2006;3:25. doi:10.1186/1743-7075-3-25.

5. Levine JA, Eberhardt NL, Jensen MD. Role of nonexercise activity thermogenesis in resistance to fat gain in humans. Science. 1999;283(5399):212–214. Available at: http://www.sciencemag.org/content/283/5399/212.long.

6. Westerterp-Plantenga MS, Nieuwenhuizen A, Tome D, Soenen S, Westerterp KR. Dietary protein, weight loss, and weight maintenance. Annu Rev Nutr. 2009;29:21–41. doi:10.1146/annurev-nutr-080508-141056.

7. Calton JB. Prevalence of micronutrient deficiency in popular diet plans. J Int Soc Sports Nutr. 2010;7:24. doi:10.1186/1550-2783-7-24.

8. Layman DK. Protein quantity and quality at levels above the RDA improves adult weight loss. J Am Coll Nutr. 2004;23(6 Suppl):631S–636S. Available at: http://pmid.us/15640518.

9. Gardner CD, Kim S, Bersamin A, et al. Micronutrient quality of weight-loss diets that focus on macronutrients: results from the A TO Z study. Am J Clin Nutr. 2010;92(2):304–312. doi:10.3945/ajcn.2010.29468.

10. King DE, Mainous AG3, Lambourne CA. Trends in dietary fiber intake in the United States, 1999-2008. J Acad Nutr Diet. 2012;112(5):642–648. doi:10.1016/j.jand.2012.01.019.

11. Rolls BJ, Ello-Martin JA, Tohill BC. What can intervention studies tell us about the relationship between fruit and vegetable consumption and weight management? Nutr Rev. 2004;62(1):1–17.

12. Vioque J, Weinbrenner T, Castello A, Asensio L, Garcia de la Hera M. Intake of fruits and vegetables in relation to 10-year weight gain among Spanish adults. Obesity (Silver Spring). 2008;16(3):664–670. doi:10.1038/oby.2007.121.

13. Sartorelli DS, Franco LJ, Cardoso MA. High intake of fruits and vegetables predicts weight loss in Brazilian overweight adults. Nutr Res. 2008;28(4):233–238. doi:10.1016/j.nutres.2008.02.004.

14. Alinia S, Hels O, Tetens I. The potential association between fruit intake and body weight–a review. Obes Rev. 2009;10(6):639–647. doi:10.1111/j.1467-789X.2009.00582.x.

15. Subar AF, Heimendinger J, Patterson BH, Krebs-Smith SM, Pivonka E, Kessler R. Fruit and vegetable intake in the United States: the baseline survey of the Five A Day for Better Health Program. Am J Health Promot. 1995;9(5):352–360.

16. Kimmons J, Gillespie C, Seymour J, Serdula M, Blanck HM. Fruit and vegetable intake among adolescents and adults in the United States: percentage meeting individualized recommendations. Medscape J Med. 2009;11(1):26.

17. Larson DE, Rising R, Ferraro RT, Ravussin E. Spontaneous overfeeding with a “cafeteria diet” in men: effects on 24-hour energy expenditure and substrate oxidation. International Journal of Obesity (2005). 1995;19(5):331–337.

18. Sorensen LB, Moller P, Flint A, Martens M, Raben A. Effect of sensory perception of foods on appetite and food intake: a review of studies on humans. International Journal of Obesity (2005). 2003;27(10):1152–1166.

19. Raynor HA, Epstein LH. Dietary variety, energy regulation, and obesity. Psychol Bull. 2001;127(3):325–341.

20. Raynor HA, Jeffery RW, Tate DF, Wing RR. Relationship between changes in food group variety, dietary intake, and weight during obesity treatment. International Journal of Obesity (2005). 2004;28(6):813–820.

21. Krolner R, Rasmussen M, Brug J, Klepp K-I, Wind M, Due P. Determinants of fruit and vegetable consumption among children and adolescents: a review of the literature. Part II: qualitative studies. Int J Behav Nutr Phys Act. 2011;8:112. doi:10.1186/1479-5868-8-112.

22. Coelho JS, Jansen A, Roefs A, Nederkoorn C. Eating behavior in response to food-cue exposure: examining the cue-reactivity and counteractive-control models. Psychol Addict Behav. 2009;23(1):131–139. doi:10.1037/a0013610.

23. Bellisle F. [Assessing various aspects of the motivation to eat that can affect food intake and body weight control]. Encephale. 2009;35(2):182–185. doi:10.1016/j.encep.2008.03.009.

24. Coelho JS, Polivy J, Herman CP, Pliner P. Wake up and smell the cookies. Effects of olfactory food-cue exposure in restrained and unrestrained eaters. Appetite. 2009;52(2):517–520. doi:10.1016/j.appet.2008.10.008.

25. Scisco JL, Muth ER, Dong Y, Hoover AW. Slowing bite-rate reduces energy intake: an application of the bite counter device. J Am Diet Assoc. 2011;111(8):1231–1235. doi:10.1016/j.jada.2011.05.005.

26. Andrade AM, Greene GW, Melanson KJ. Eating slowly led to decreases in energy intake within meals in healthy women. J Am Diet Assoc. 2008;108(7):1186–1191. doi:10.1016/j.jada.2008.04.026.

27. Andrade AM, Kresge DL, Teixeira PJ, Baptista F, Melanson KJ. Does eating slowly influence appetite and energy intake when water intake is controlled? Int J Behav Nutr Phys Act. 2012;9:135. doi:10.1186/1479-5868-9-135.

28. Wansink B, Payne CR, Chandon P. Internal and external cues of meal cessation: the French paradox redux? Obesity (Silver Spring). 2007;15(12):2920–2924. doi:10.1038/oby.2007.348.

29. de Castro JM. Eating behavior: lessons from the real world of humans. Nutrition. 2000;16(10):800–813.

30. Herman CP, Roth DA, Polivy J. Effects of the presence of others on food intake: a normative interpretation. Psychol Bull. 2003;129(6):873–886.

31. Bell R, Pliner PL. Time to eat: the relationship between the number of people eating and meal duration in three lunch settings. Appetite. 2003;41(2):215–218.

32. Wansink B. Environmental factors that increase the food intake and consumption volume of unknowing consumers. Annu Rev Nutr. 2004;24:455–479. doi:10.1146/annurev.nutr.24.012003.132140.

33. Wansink B. From mindless eating to mindlessly eating better. Physiol Behav. 2010;100(5):454–463. doi:10.1016/j.physbeh.2010.05.003.

34. Stroebele N, de Castro JM. Effect of ambience on food intake and food choice. Nutrition. 2004;20(9):821–838.

35. Wansink B, Payne CR. Counting bones: environmental cues that decrease food intake. Percept Mot Skills. 2007;104(1):273–276.

36. Wansink B, Painter JE, North J. Bottomless bowls: why visual cues of portion size may influence intake. Obes Res. 2005;13(1):93–100. doi:10.1038/oby.2005.12.

37. Lowe MR, Levine AS. Eating motives and the controversy over dieting: eating less than needed versus less than wanted. Obes Res. 2005;13(5):797–806. doi:10.1038/oby.2005.90.

38. Wu T, Gao X, Chen M, van Dam RM. Long-term effectiveness of diet-plus-exercise interventions vs. diet-only interventions for weight loss: a meta-analysis. Obes Rev. 2009;10(3):313–323. doi:10.1111/j.1467-789X.2008.00547.x.

39. Curioni CC, Lourenco PM. Long-term weight loss after diet and exercise: a systematic review. International Journal of Obesity (2005). 2005;29(10):1168–1174. doi:10.1038/sj.ijo.0803015.

40. Liu J-H, Jones SJ, Sun H, Probst JC, Merchant AT, Cavicchia P. Diet, physical activity, and sedentary behaviors as risk factors for childhood obesity: an urban and rural comparison. Child Obes. 2012;8(5):440–448. doi:10.1089/chi.2012.0090.

41. Phelan S, Wyatt HR, Hill JO, Wing RR. Are the eating and exercise habits of successful weight losers changing? Obesity (Silver Spring). 2006;14(4):710–716. doi:10.1038/oby.2006.81.

42. Tate DF, Jeffery RW, Sherwood NE, Wing RR. Long-term weight losses associated with prescription of higher physical activity goals. Are higher levels of physical activity protective against weight regain? Am J Clin Nutr. 2007;85(4):954–959.

43. Jakicic JM, Marcus BH, Lang W, Janney C. Effect of exercise on 24-month weight loss maintenance in overweight women. Arch Intern Med. 2008;168(14):1550–9– discussion 1559–60. doi:10.1001/archinte.168.14.1550.

44. Levine JA, Schleusner SJ, Jensen MD. Energy expenditure of nonexercise activity. Am J Clin Nutr. 2000;72(6):1451–1454.

45. Levine JA. Nonexercise activity thermogenesis (NEAT): environment and biology. Am J Physiol Endocrinol Metab. 2004;286(5):E675–85. Available at: http://ajpendo.physiology.org/content/286/5/E675.long.

46. Levine JA, Lanningham-Foster LM, McCrady SK, et al. Interindividual variation in posture allocation: possible role in human obesity. Science. 2005;307(5709):584–586. doi:10.1126/science.1106561.

47. Wansink B, Sobal J. Mindless Eating: The 200 Daily Food Decisions We Overlook. Environment and Behavior. 2007;39(1):106–123.

48. Hofmann W, Baumeister RF, Forster G, Vohs KD. Everyday temptations: an experience sampling study of desire, conflict, and self-control. J Pers Soc Psychol. 2012;102(6):1318–1335. doi:10.1037/a0026545.

49. Hofmann W, Vohs KD, Baumeister RF. What people desire, feel conflicted about, and try to resist in everyday life. Psychol Sci. 2012;23(6):582–588. doi:10.1177/0956797612437426.

50. Will Crescioni A, Ehrlinger J, Alquist JL, et al. High trait self-control predicts positive health behaviors and success in weight loss. J Health Psychol. 2011;16(5):750–759. doi:10.1177/1359105310390247.

51. Hofmann W, Adriaanse M, Vohs KD, Baumeister RF. Dieting and the self-control of eating in everyday environments: An experience sampling study. Br J Health Psychol. 2013. doi:10.1111/bjhp.12053.

52. Kuijer R, de Ridder D, Ouwehand C, Houx B, van den Bos R. Dieting as a case of behavioural decision making. Does self-control matter? Appetite. 2008;51(3):506–511. doi:10.1016/j.appet.2008.03.014.

53. Clarkson JJ, Hirt ER, Jia L, Alexander MB. When perception is more than reality: the effects of perceived versus actual resource depletion on self-regulatory behavior. J Pers Soc Psychol. 2010;98(1):29–46. doi:10.1037/a0017539.

54. Chernev A. The Dieter’s Paradox. Journal of Consumer Psychology. 2010;(21):178–183. Available at: http://The Dieter’s Paradox – Kellogg School of Management …

55. Yanetz R, Kipnis V, Carroll RJ, et al. Using biomarker data to adjust estimates of the distribution of usual intakes for misreporting: application to energy intake in the US population. J Am Diet Assoc. 2008;108(3):455–64– discussion 464. doi:10.1016/j.jada.2007.12.004.

56. Millen AE, Tooze JA, Subar AF, Kahle LL, Schatzkin A, Krebs-Smith SM. Differences between food group reports of low-energy reporters and non-low-energy reporters on a food frequency questionnaire. J Am Diet Assoc. 2009;109(7):1194–1203. doi:10.1016/j.jada.2009.04.004.

57. Tooze JA, Vitolins MZ, Smith SL, et al. High levels of low energy reporting on 24-hour recalls and three questionnaires in an elderly low-socioeconomic status population. J Nutr. 2007;137(5):1286–1293. Available at: http://jn.nutrition.org/content/137/5/1286.long.

58. Lichtman SW, Pisarska K, Berman ER, et al. Discrepancy between self-reported and actual caloric intake and exercise in obese subjects. N Engl J Med. 1992;327(27):1893–1898. doi:10.1056/NEJM199212313272701.

59. Price GM, Paul AA, Cole TJ, Wadsworth ME. Characteristics of the low-energy reporters in a longitudinal national dietary survey. Br J Nutr. 1997;77(6):833–851.

60. Pryer JA, Vrijheid M, Nichols R, Kiggins M, Elliott P. Who are the “low energy reporters” in the dietary and nutritional survey of British adults? Int J Epidemiol. 1997;26(1):146–154.

61. Brehm BJ, Spang SE, Lattin BL, Seeley RJ, Daniels SR, D’Alessio DA. The role of energy expenditure in the differential weight loss in obese women on low-fat and low-carbohydrate diets. J Clin Endocrinol Metab. 2005;90(3):1475–1482. doi:10.1210/jc.2004-1540.

62. Burrows TL, Martin RJ, Collins CE. A systematic review of the validity of dietary assessment methods in children when compared with the method of doubly labeled water. J Am Diet Assoc. 2010;110(10):1501–1510. doi:10.1016/j.jada.2010.07.008.

63. Cook A, Pryer J, Shetty P. The problem of accuracy in dietary surveys. Analysis of the over 65 UK National Diet and Nutrition Survey. J Epidemiol Community Health. 2000;54(8):611–616.

64. Maurer J, Taren DL, Teixeira PJ, et al. The psychosocial and behavioral characteristics related to energy misreporting. Nutr Rev. 2006;64(2 Pt 1):53–66.

65. Rennie MJ, Bohe J, Smith K, Wackerhage H, Greenhaff P. Branched-chain amino acids as fuels and anabolic signals in human muscle. J Nutr. 2006;136(1 Suppl):264S–8S. Available at: http://pmid.us/16365095.

66. Johansson L, Solvoll K, Bjorneboe GE, Drevon CA. Under- and overreporting of energy intake related to weight status and lifestyle in a nationwide sample. Am J Clin Nutr. 1998;68(2):266–274.

67. Poslusna K, Ruprich J, de Vries JHM, Jakubikova M, van’t Veer P. Misreporting of energy and micronutrient intake estimated by food records and 24 hour recalls, control and adjustment methods in practice. Br J Nutr. 2009;101 Suppl 2:S73–85. doi:10.1017/S0007114509990602.

68. Livingstone MBE, Black AE. Markers of the validity of reported energy intake. J Nutr. 2003;133 Suppl 3:895S–920S.

69. Pietilaninen KH, Korkeila M, Bogl LH, et al. Inaccuracies in food and physical activity diaries of obese subjects: complementary evidence from doubly labeled water and co-twin assessments. International Journal of Obesity (2010). 2010;34:37–445.

70. Ferrari P, Slimani N, Ciampi A, et al. Evaluation of under- and overreporting of energy intake in the 24-hour diet recalls in the European Prospective Investigation into Cancer and Nutrition (EPIC). Public Health Nutr. 2002;5(6B):1329–1345. doi:10.1079/PHN2002409.

71. Azizi F, Esmaillzadeh A, Mirmiran P. Correlates of under- and over-reporting of energy intake in Tehranians: body mass index and lifestyle-related factors. Asia Pac J Clin Nutr. 2005;14(1):54–59.

72. Buhl KM, Gallagher D, Hoy K, Matthews DE, Heymsfield SB. Unexplained disturbance in body weight regulation: diagnostic outcome assessed by doubly labeled water and body composition analyses in obese patients reporting low energy intakes. J Am Diet Assoc. 1995;95(12):1393–400– quiz 1401–2. doi:10.1016/S0002-8223(95)00367-3.

73. Samaras K, Kelly PJ, Campbell LV. Dietary underreporting is prevalent in middle-aged British women and is not related to adiposity (percentage body fat). International Journal of Obesity (2005). 1999;23(8):881–888.

74. Lafay L, Mennen L, Basdevant A, et al. Does energy intake underreporting involve all kinds of food or only specific food items? Results from the Fleurbaix Laventie Ville Sante (FLVS) study. International Journal of Obesity (2005). 2000;24(11):1500–1506.

75. Lafay L, Basdevant A, Charles MA, et al. Determinants and nature of dietary underreporting in a free-living population: the Fleurbaix Laventie Ville Sante (FLVS) Study. International Journal of Obesity (2005). 1997;21(7):567–573.

76. Garriguet D. Under-reporting of energy intake in the Canadian Community Health Survey. Health Rep. 2008;19(4):37–45.

77. Shahar DR, Yu B, Houston DK, et al. Misreporting of energy intake in the elderly using doubly labeled water to measure total energy expenditure and weight change. J Am Coll Nutr. 2010;29(1):14–24.

78. Krebs-Smith SM, Graubard BI, Kahle LL, Subar AF, Cleveland LE, Ballard-Barbash R. Low energy reporters vs others: a comparison of reported food intakes. Eur J Clin Nutr. 2000;54(4):281–287.

79. Bratteby LE, Sandhagen B, Fan H, Enghardt H, Samuelson G. Total energy expenditure and physical activity as assessed by the doubly labeled water method in Swedish adolescents in whom energy intake was underestimated by 7-d diet records. Am J Clin Nutr. 1998;67(5):905–911.

80. Tooze JA, Subar AF, Thompson FE, Troiano R, Schatzkin A, Kipnis V. Psychosocial predictors of energy underreporting in a large doubly labeled water study. Am J Clin Nutr. 2004;79(5):795–804.

81. Rennie KL, Siervo M, Jebb SA. Can self-reported dieting and dietary restraint identify underreporters of energy intake in dietary surveys? J Am Diet Assoc. 2006;106(10):1667–1672. doi:10.1016/j.jada.2006.07.014.

82. Macdiarmid J, Blundell J. Assessing dietary intake: Who, what and why of under-reporting. Nutr Res Rev. 1998;11(2):231–253. doi:10.1079/NRR19980017.

83. Bathalon GP, Tucker KL, Hays NP, et al. Psychological measures of eating behavior and the accuracy of 3 common dietary assessment methods in healthy postmenopausal women. Am J Clin Nutr. 2000;71(3):739–745.

84. Ventura AK, Loken E, Mitchell DC, Smiciklas-Wright H, Birch LL. Understanding reporting bias in the dietary recall data of 11-year-old girls. Obesity (Silver Spring). 2006;14(6):1073–1084. doi:10.1038/oby.2006.123.

85. Champagne CM, Bray GA, Kurtz AA, et al. Energy intake and energy expenditure: a controlled study comparing dietitians and non-dietitians. J Am Diet Assoc. 2002;102(10):1428–1432.

86. Bedard D, Shatenstein B, Nadon S. Underreporting of energy intake from a self-administered food-frequency questionnaire completed by adults in Montreal. Public Health Nutr. 2004;7(5):675–681.

87. Hendrickson S, Mattes R. Financial incentive for diet recall accuracy does not affect reported energy intake or number of underreporters in a sample of overweight females. J Am Diet Assoc. 2007;107(1):118–121. doi:10.1016/j.jada.2006.10.003.

88. Muhlheim LS, Allison DB, Heshka S, Heymsfield SB. Do unsuccessful dieters intentionally underreport food intake? Int J Eat Disord. 1998;24(3):259–266. doi:10.1002/(SICI)1098-108X(199811)24:3<259::AID-EAT3>3.0.CO;2-L.

89. Black AE, Goldberg GR, Jebb SA, Livingstone MB, Cole TJ, Prentice AM. Critical evaluation of energy intake data using fundamental principles of energy physiology: 2. Evaluating the results of published surveys. Eur J Clin Nutr. 1991;45(12):583–599.

90. Singh R, Martin BR, Hickey Y, et al. Comparison of self-reported, measured, metabolizable energy intake with total energy expenditure in overweight teens. Am J Clin Nutr. 2009;89(6):1744–1750. doi:10.3945/ajcn.2008.26752.

91. Bingham SA, Day NE. Using biochemical markers to assess the validity of prospective dietary assessment methods and the effect of energy adjustment. Am J Clin Nutr. 1997;65(4 Suppl):1130S–1137S.

92. Black AE, Bingham SA, Johansson G, Coward WA. Validation of dietary intakes of protein and energy against 24 hour urinary N and DLW energy expenditure in middle-aged women, retired men and post-obese subjects: comparisons with validation against presumed energy requirements. Eur J Clin Nutr. 1997;51(6):405–413.

93. Novotny JA, Rumpler WV, Riddick H, et al. Personality characteristics as predictors of underreporting of energy intake on 24-hour dietary recall interviews. J Am Diet Assoc. 2003;103(9):1146–1151.

94. Heerstrass DW, Ocke MC, Bueno-de-Mesquita HB, Peeters PH, Seidell JC. Underreporting of energy, protein and potassium intake in relation to body mass index. Int J Epidemiol. 1998;27(2):186–193.

95. Zhang J, Temme EH, Sasaki S, Kesteloot H. Under- and overreporting of energy intake using urinary cations as biomarkers: relation to body mass index. Am J Epidemiol. 2000;152(5):453–462.

96. Scagliusi FB, Ferriolli E, Pfrimer K, et al. Underreporting of energy intake in Brazilian women varies according to dietary assessment: a cross-sectional study using doubly labeled water. J Am Diet Assoc. 2008;108(12):2031–2040. doi:10.1016/j.jada.2008.09.012.

97. Heitmann BL. The influence of fatness, weight change, slimming history and other lifestyle variables on diet reporting in Danish men and women aged 35-65 years. International Journal of Obesity (2005). 1993;17(6):329–336.

98. Scagliusi FB, Polacow VO, Artioli GG, Benatti FB, Lancha AHJ. Selective underreporting of energy intake in women: magnitude, determinants, and effect of training. J Am Diet Assoc. 2003;103(10):1306–1313.

99. Heitmann BL, Lissner L. Dietary underreporting by obese individuals–is it specific or non-specific? BMJ. 1995;311(7011):986–989. doi:10.1136/bmj.311.7011.986.

100. Hebert JR, Peterson KE, Hurley TG, et al. The effect of social desirability trait on self-reported dietary measures among multi-ethnic female health center employees. Ann Epidemiol. 2001;11(6):417–427.

101. Johnson RK, Soultanakis RP, Matthews DE. Literacy and body fatness are associated with underreporting of energy intake in US low-income women using the multiple-pass 24-hour recall: a doubly labeled water study. J Am Diet Assoc. 1998;98(10):1136–1140. doi:10.1016/S0002-8223(98)00263-6.

102. Taren DL, Tobar M, Hill A, et al. The association of energy intake bias with psychological scores of women. Eur J Clin Nutr. 1999;53(7):570–578.

103. Horner NK, Patterson RE, Neuhouser ML, Lampe JW, Beresford SA, Prentice RL. Participant characteristics associated with errors in self-reported energy intake from the Women’s Health Initiative food-frequency questionnaire. Am J Clin Nutr. 2002;76(4):766–773.

104. Willbond SM, Laviolette MA, Duval K, Doucet E. Normal weight men and women overestimate exercise energy expenditure. J Sports Med Phys Fitness. 2010;50(4):377–384.

105. Burke LE, Wang J, Sevick MA. Self-monitoring in weight loss: a systematic review of the literature. J Am Diet Assoc. 2011;111(1):92–102. doi:10.1016/j.jada.2010.10.008.

106. Boutelle KN, Kirschenbaum DS. Further support for consistent self-monitoring as a vital component of successful weight control. Obes Res. 1998;6(3):219–224.

107. Hollis JF, Gullion CM, Stevens VJ, et al. Weight loss during the intensive intervention phase of the weight-loss maintenance trial. Am J Prev Med. 2008;35(2):118–126. doi:10.1016/j.amepre.2008.04.013.

108. Andaya AA, Arredondo EM, Alcaraz JE, Lindsay SP, Elder JP. The association between family meals, TV viewing during meals, and fruit, vegetables, soda, and chips intake among Latino children. J Nutr Educ Behav. 2011;43(5):308–315. doi:10.1016/j.jneb.2009.11.005.

109. Scarpace PJ, Zhang Y. Leptin resistance: a prediposing factor for diet-induced obesity. Am J Physiol Regul Integr Comp Physiol. 2009;296(3):R493–500. doi:10.1152/ajpregu.90669.2008.

110. Chu NF, Stampfer MJ, Spiegelman D, Rifai N, Hotamisligil GS, Rimm EB. Dietary and lifestyle factors in relation to plasma leptin concentrations among normal weight and overweight men. International Journal of Obesity (2005). 2001;25(1):106–114.

111. Mason C, Foster-Schubert KE, Imayama I, et al. Dietary weight loss and exercise effects on insulin resistance in postmenopausal women. Am J Prev Med. 2011;41(4):366–375. doi:10.1016/j.amepre.2011.06.042.

112. Hawley JA, Lessard SJ. Exercise training-induced improvements in insulin action. Acta Physiol (Oxf). 2008;192(1):127–135. doi:10.1111/j.1748-1716.2007.01783.x.

113. Zhang Y, Scarpace PJ. The role of leptin in leptin resistance and obesity. Physiol Behav. 2006;88(3):249–256. doi:10.1016/j.physbeh.2006.05.038.

114. Scarpace PJ, Zhang Y. Elevated leptin: consequence or cause of obesity? Front Biosci. 2007;12:3531–3544.

115. Myers MGJ, Leibel RL, Seeley RJ, Schwartz MW. Obesity and leptin resistance: distinguishing cause from effect. Trends Endocrinol Metab. 2010;21(11):643–651. doi:10.1016/j.tem.2010.08.002.

116. Smith SR. The endocrinology of obesity. Endocrinol Metab Clin North Am. 1996;25(4):921–942.

117. Walley AJ, Blakemore AIF, Froguel P. Genetics of obesity and the prediction of risk for health. Human Molecular Genetics. 2006;15(suppl 2):R124–R130. Available at: http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2955913/.

118. Ali AT, Crowther NJ. Factors predisposing to obesity: a review of the literature. Journal of Endocrinology, Metabolism and Diabetes of South Africa. 2009;14(2):81–84. Available at: http://www.ajol.info/index.php/jemdsa/article/viewFile/50350/39036.

119. Baumeister RF, Gailliot M, DeWall CN, Oaten M. Self-regulation and personality: how interventions increase regulatory success, and how depletion moderates the effects of traits on behavior. J Pers. 2006;74(6):1773–1801. doi:10.1111/j.1467-6494.2006.00428.x.

120. Muraven M. Building self-control strength: Practicing self-control leads to improved self-control performance. Journal of Experimental Social Psychology. 2010;46(2):465–468. doi:http://dx.doi.org/10.1016/j.jesp.2009.12.011.

Comments

  1. Mark Shields says

    Splendid article. To the point, blunt , yet not condescending or judgmental. Putting the ball in the individual’s court for them to be able to action steps. Bravo

  2. says

    Great article, Armi. Guyenet is a favorite of mine, so I was glad you linked to his work. I’m also very pro-personal responsibility.

  3. Ross says

    Another well researched and thought provoking article- thanks Armi. It’s great to have a clear, efficient summary of body weight control. I also think the personal responsibility stance is spot on but unfortunately the average member of society has a lot of mis-information to wade through before they come to the conclusion in the article. The commercial food/diet industry love to promote ‘easy’ /fad diets, rather than the distinctly non-profitable truths listed in your article.

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  5. Caiti says

    I do actually agree with this article, but it doesnt address particular situations where fat loss stalls for other reasons. A couple months ago I was eating 800-1000 calories per day and exercising at least 2-3 hours a day and not losing weight. I have been counting calories for 7 years so I am pretty good at it and tend to overestimate or add 50,100 or so calories here and there throughout the day because I know there is a greater chance of underestimating. I understand this is more eating disorder behaviour, which I have struggled with for many years, and I have been trying to eat more since then to gain my muscle mass back and I eat generally 1500-1800 calories per day now and do 30-60 minutes of high intensity cardio/strength training per day. I gained 10 lbs while trying to eat more in the last couple of months, but eventually I plan to cut calories again to see if that helps move the plateau. I agree with this article but it is not all inclusive of every fat loss situation. Sometimes its not always “if your fat, youre just not exercising enough and youre eating too much”.

    • Camila says

      agreed. And in no way does this information apply to those recovering from eating disorders or in remission from them.

  6. LJ Thomas says

    Invariably, those of us who have difficulty losing weight are always told it’s our own fault. Apparently, we are all either liars, stupid, or in denial. We always get the the old condescending “calories in, calories out” principle thrown in our faces.

    Let me tell you something. I have no reason to “fudge” facts when I’m unhappy with my weight and looking for answers. I am following a very consistent food plan prescribed by a top nutritionist in my area and designed personally for me. It has been praised by both my personal gym trainer and my doctor. I workout 3 days a week, and I walk briskly 3 miles a day on the in between days. I have hypothyroidism, but with medication, my test results have been in the normal for over a year.

    Despite all this, I am still severely obese and cannot lose fat. I have lost only 6 pounds in one year! At that rate, it will take me 12 years to be a normal size, and I doubt I will still be alive by then.

    I’m sorry, but you do not understand the physiology of all “fat” people”, and your article serves no purpose except to reinforce your belief that it’s our fault and we are not being honest with our food and exercise habits. This only adds to the deep depression and helplessness that many of us suffer who cannot lose weight.

    I also expect that you will not publish this comment because it does not validate your flawed and unfair assessment of all of those who suffer from weight control issues.

    • says

      Thanks for the comment LJ.

      we are all either liars, stupid, or in denial. We always get the the old condescending “calories in, calories out” principle thrown in our faces.

      Where did the article call you a liar, stupid, or say you are in denial?

      I am following a very consistent food plan prescribed by a top nutritionist in my area and designed personally for me. It has been praised by both my personal gym trainer and my doctor. I workout 3 days a week, and I walk briskly 3 miles a day on the in between days.

      That’s great LJ — truly. It sounds like you’re doing a good job, but it doesn’t matter who created your meal plan. Countless studies have shown that if you aren’t in a calorie deficit, you won’t lose weight.

      I’m sorry, but you do not understand the physiology of all “fat” people”, and your article serves no purpose except to reinforce your belief that it’s our fault and we are not being honest with our food and exercise habits. This only adds to the deep depression and helplessness that many of us suffer who cannot lose weight.

      Please explain to me how your physiology differs from leaner people in regard to fat loss. And again, please show me exactly where the article stated being fat was all your fault.

      I also expect that you will not publish this comment because it does not validate your flawed and unfair assessment of all of those who suffer from weight control issues.

      On the contrary, I’m glad you left this comment, and I want others to see it to so they don’t misunderstand me, as I think you may have.

      • LJ Thomas says

        Apparently, my nutritionist and my doctor are clueless, too? They don’t that I need to be in a calorie deficit and are prescribing a diet that is providing too many calories for my needs? A person my size according to BMR calculations, even if sedentary, would generally require around 2500 calotires just to maintain their weight. My food plan gives me 1500 calories a day. Less than that and I would not have the energy for 3 intense workouts with my trainer per week plus 3 miles a day of walking. When I am not exercising, I stand at my computer–not sit. I also garden and enjoy a variety of activities.

        My point is simply that some people have a very very difficult problem losing weight even in a calorie deficit with physical activity. Your theory does not respect that. End of discussion. I am not going to beat a dead horse.

        • says

          Thanks for the response LJ. It sounds like you’re probably underestimating your food intake. It’s not just overweight people who do it, that includes lean people too. I’m sorry if you think that’s offensive.

    • James says

      I have been struggling with my weight for ever. And agree everyone tells me it is my own fault. Like I cheat on my diets or am just in denial. I come from a family of 6 2 girls who weight around 100 pounds wet. and i have 3 brothers. All who eat so much more then me its not funny. there all 6ft and around 140 pounds. Then you have me i am at this time 260 pounds. I eat around 1500 calories a day. I can run for miles. work 10 hrs a day physically. I can put everyone i know to shame in any sport. Yet i am fat. I have weighed over 200 pounds since i was 14. I am 25 now. I struggle to maintain my weight as it is. I went on a binge for a few months last year and ended up at 315 pounds by the end. Its depressing. The only thing i notice is although i gain fat super easy i gain muscle most cant get on roids. Don’t be fooled its all in your genes.

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  8. says

    Hi, I am 53 years old and for the first time in my life I am at a proper weight. I struggled all my life to try and lose weight but I never was that committed, or shall I say, able to stick to a weight loss program long enought to lose the fat.

    When I was at my heaviest I was 235 pounds, I am not 155 pounds and am 5’7″–People ask me how I ever managed to lose this weight. Well in 2008 I went through a personal crisis which spurred me to do something for myself, to make myself feel good and which no one could take away,

    I signed up at Weight Watchers in Sydney, Australia, where I lived. I was familiar with the program, having had success with it in my 30s in the USA.

    It was not easy, but I managed to lose 37 pounds, and felt terrific. I was stuck at that weight for the next five years–why? Because I felt great about losing that weight, and got complacent. i would still go to weekly meetings at WW and pay the $20 fee and listen to the leader. I felt that I was doing my part…but really, was i? I was sliding, nibbling on stuff and not including them in my food journal, getting slack with my portions, etc. And some of the weight creeped back on (about 7 pounds or so).

    Then, in May 2013, I decided to go on the COHEN Weight Loss Program. I saw many people have success with this, and when my own sister managed to lose 35 pounds in four months, it got my attention (specially since I kept insisting WW was working for me when it clearly wasn’t).

    At this point I was still going to WW meetings, doing Zumba, Hiphop, Jazz and Salsa dancing 2x a week, going to the gym with a personal trainer 2x a week and walking on days when I was not doing the above.

    When I began the COHEN Weight loss program I was told that I need not exercise as it might increase my appetite. So I did NOT exercise. I stuck with the program, which requires strict portioning and only has a small list of allowed food. I committed to it and removed every single type of food from my apartment that was not allowed.

    I lose 42 pounds in four months. For the FIRST time in my life I am at a proper weight and I am 53! All I can say is, sometimes you feel you can NEVER make it, never lose weight, and will be FAT forever. BUT IT IS NOT TRUE. The program stopped my cravings for processed food, sugar, and empty white carbs. I now eat properly and while i have gained 6 pounds since last year, I am going back on the program to lose it. I will NEVER go back to how I was before!

    If someone like ME can do this, SO CAN ANYONE! I am not superwoman, I merely changed my behaviour. Addressing the problem and finding a program that worked was the solution, but above all, changing my behaviour brought the results.

    • Armi Legge says

      Thanks Isabel! I’m thrilled you’re finally happy with your body and at a healthier weight. It sounds like you’ve had a hard journey, and luckily you’ve found something that works. What was the hardest part about your transformation?

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