We have been told that all it takes to lose weight is a reduction in calories and/or an increase in energy expenditure (exercise). So if we eat less calories or exercise more or both, we will lose weight. Supposedly, that’s how it works.

And yet, we continue to struggle with losing weight and keeping it off for good. Only a small percentage of overweight and obese people are able to maintain a weight loss of ten percent of body weight for one year.1 The reason for this goes beyond the simple calories in/calories out calculation. What researchers are discovering is that a calorie is not just a calorie. Rather, it’s the quality of the diet as a whole that determines whether a person will be able to lose weight and keep it off or not.

A recent paper published in the Journal of the American Medical Association proposes a new model of obesity that better explains why and how we get fat.2 The current model states that the Standard American Diet (SAD), full of convenient, highly palatable, energy-dense foods, causes people to overeat, which increases energy intake (calories in), while a sedentary lifestyle decrease energy expenditure (calories out). As a result, circulating fuels in the bloodstream (glucose from sugar and carbs, fatty acids from fats, and ketones from proteins) are more available, which increases fat storage and leads to obesity.

The new model proposes that diet quality—especially carbohydrate amount and type—as well as genetics and lifestyle factors such as inadequate sleep and stress, all contribute to an increase of fat storage, which decreases the circulating fuels in the bloodstream (sugar, fat, and ketones), triggering hunger (calories in) and lowering metabolism (which lowers the burning of calories). The result—obesity.

This new model helps explain why a calorie is not just a calorie and supports the fact that a low-carbohydrate diet versus a low-fat, high-carbohydrate diet of equal calories results in better weight loss, blood sugar control, and cholesterol levels.3 It also explains why a low- vs high-glycemic index diet (glycemic index measures the ability of a food to raise blood sugar) of equal calories decreases hunger.4

Other dietary factors that decrease fat storage (thus increasing the available fuel in circulation which quells hunger and improves metabolism) are a low refined sugar intake, high omega-3 and low trans fat intake, adequate protein, high micronutrient and phytochemical content (in other words, plenty of fruits and vegetables), and probiotics and prebiotics.1 We see a high quality of foods in these recommendations, coming back to the advice that the quality of diet is what is most important when it comes to weight loss.

So if you think that overeating causes you to be fat, it’s actually a poor quality of diet that causes overeating, which causes you to be fat. How can you improve your diet quality? Here are some tips:

  • Eat plenty of non-starchy vegetables and low-sugar fruits.
  • Eliminate sugar and grains.
  • Eat healthy fats such as omega-3 (fish oil), omega-9 (olive oil), and medium-chain triglyceride saturated fat (coconut oil), and reduce your intake of unhealthy omega-6 fats (most vegetable oils).
  • Eat protein throughout the day.
  • Eat fermented foods, which contain beneficial bacteria.

In conclusion, following the above dietary suggestions along with moderate caloric restriction with optimum nutrition (CRON) and exercise and stress reduction not only leads to permanent weight management, it is also the recipe for adding years to your life as well as life to your years.


  1. Kraschnewski JL, Boan J, Esposito J, et al., “Long-term weight loss maintenance in the United States.” Int J Obes (Lond). 2010 Nov;34(11):1644-54.
  2. Ludwig DS, Friedman MI, “Increasing adiposity: consequence or cause of overeating?” JAMA. 2014 Jun 4;311(21):2167-8.
  3. Shai I, Schwartzfuchs D, Henkin Y, et al., “Weight loss with a low-carbohydrate, Mediterranean, or low-fat diet.” N Engl J Med. 2008 Jul 17;359(3):229-41.
  4. Chang KT, Lampe JW, Schwartz Y, “Low glycemic load experimental diet more satiating than high glycemic load diet.” Nutr Cancer. 2012;64(5):666-73.