Medical Review Process and Limitations

What "review" means on this site

SquarepegIdeas is not a medical organization. We do not employ licensed physicians, registered dietitians, or other licensed health practitioners as part of the editorial team. The site publishes calculators and educational material for general informational use. It does not provide clinical care.

Our review process is editorial review for accuracy against published research. It is not clinical review for individual applicability. An editor checks whether the formula, explanation, and cited support match the published source. That process can catch unsupported claims, calculation mistakes, unclear wording, and outdated source references. It cannot determine whether a calorie target, macro split, supplement, or diet change is appropriate for a specific reader with a specific medical history.

When a page says it was reviewed by the SquarepegIdeas Editorial Team, it means the content was checked against its cited sources before publication or update. It does not mean a clinician evaluated the advice for any individual reader. We avoid medical-review language that would imply physician oversight we do not have.

This distinction is deliberate. Some nutrition sites use medical language broadly, even when the review is mostly editorial. We choose narrower wording because it is more accurate. If a page needs clinical review in the future, that reviewer should be named with appropriate credentials and the scope of that review should be stated on the page.

What we verify before publishing

We verify calculator math against the originally published formula whenever the original source is available. For TDEE and BMR tools, that includes formulas such as Mifflin-St Jeor (Mifflin et al. 1990), the Roza and Shizgal revision of Harris-Benedict (Roza and Shizgal 1984), and Katch-McArdle when lean body mass is supplied. We also check unit conversions, rounding behavior, and edge cases that can change the output.

Claims about nutrition, metabolism, training, or body composition must be traceable to a source listed or named in the content. Primary research, professional position statements, and government guidelines receive the most weight. For protein guidance in resistance-trained adults, for example, we cite research reviews such as Helms, Aragon, and Fitschen (2014) rather than relying on unsourced gym rules.

Claims about specific populations receive extra caution. Pregnancy and lactation guidance should point to ACOG or equivalent professional guidance. Older-adult protein guidance should point to professional sources such as ESPEN where relevant. For adolescents, people with chronic disease, and people taking medications that affect appetite or metabolism, we limit the claim and direct readers to qualified professionals.

Where published evidence is mixed or limited, the content must reflect that uncertainty. We do not convert a weak signal into a strong recommendation. We also remove claims that depend on AI-generated text, product marketing, anecdotes, or secondary summaries that do not point back to a verifiable source.

We also verify the warning language around special populations. A calculator page should not imply that a general adult equation is validated for pregnancy, lactation, adolescence, active disease, or recovery from an eating disorder. If a page cannot address a population with suitable evidence, the correct editorial action is to narrow the audience and refer readers to a qualified professional.

What we do not claim

We do not provide individualized medical or nutritional advice. Calculator outputs are population-level estimates based on limited inputs. They may be reasonable starting points for many healthy adults, but they may not fit your medical history, medication use, training status, pregnancy status, recovery needs, or relationship with food.

We do not diagnose, treat, cure, or prevent disease. A calculator cannot diagnose thyroid disease, diabetes, malnutrition, an eating disorder, hormonal dysfunction, or any other condition. It also cannot determine whether symptoms such as fatigue, dizziness, rapid weight change, loss of menstrual cycle, or persistent hunger require medical evaluation.

We do not replace consultation with a registered dietitian for personalized nutrition planning. This is especially relevant for people with diabetes, kidney disease, liver disease, gastrointestinal disease, eating disorders, pregnancy, lactation, food allergies, tube feeding needs, or any condition requiring medical nutrition therapy. Professional nutrition care accounts for labs, symptoms, medications, clinical goals, food access, and follow-up.

We do not replace consultation with a physician for medical decisions about weight management, supplementation, or dietary changes that interact with medications. If a diet change could affect blood glucose, blood pressure, kidney function, thyroid medication, psychiatric medication, or pregnancy care, it belongs in a clinical conversation.

We also do not monitor readers after they use a tool. No one on the editorial team sees symptoms, lab results, medication changes, menstrual changes, blood pressure, glucose readings, or signs of underfueling. Without that follow-up, a website cannot safely manage a medical nutrition plan. Ongoing monitoring belongs with a clinician who can adjust advice as the facts change.

When to consult a professional

Consult a physician, registered dietitian, or other qualified clinician before making significant dietary changes if you are pregnant, breastfeeding, or trying to conceive. ACOG publishes nutrition guidance for pregnancy, but a calculator cannot account for your prenatal history, fetal growth, nausea, anemia, gestational diabetes risk, or medication plan.

Get professional guidance if you have or are recovering from an eating disorder, have diabetes, kidney disease, liver disease, thyroid disease, Cushing's syndrome, gastrointestinal disease, or any condition affecting metabolism or nutrient needs. The same applies if you take medications that affect appetite, glucose regulation, fluid balance, heart rate, mood, or thyroid function.

Professional guidance is also appropriate if you are under 18, over 65, have unintentionally lost or gained more than 10% of bodyweight in the past six months, have an active medical condition, or plan an aggressive weight-loss phase. Adolescents and older adults have nutrition needs that are not well represented by general adult calculators. Rapid unintentional weight change can signal a medical issue that should not be handled with a calorie target alone.

To find a registered dietitian in the United States, the Academy of Nutrition and Dietetics maintains a Find a Nutrition Expert directory at eatright.org. In the United Kingdom, the British Dietetic Association maintains a Find a Dietitian directory at bda.uk.com. Most countries have equivalent professional registries or national dietetic associations.

For mental health concerns related to eating, body image, restriction, binge eating, purging, or compulsive exercise, contact a physician or mental health professional directly. In the United States, the National Eating Disorders Association lists screening, treatment, and support resources. ANAD also operates an eating disorders helpline and peer support services. International readers should use an equivalent national eating disorder or mental health resource.

Professional support is not limited to emergencies. A reader who feels unable to increase calories despite weight loss, feels compelled to earn food through exercise, repeatedly cycles between restriction and overeating, or uses calculator results to justify unsafe targets should stop using the tool for self-direction and seek help. These patterns need human assessment, not a lower calorie target.

Calculator limitations specific to medical contexts

TDEE and BMR formulas were validated primarily on adult populations that do not capture every medical context. Accuracy is reduced for individuals with metabolic conditions such as thyroid disorders or Cushing's syndrome, people taking corticosteroids, some psychiatric medications, beta blockers, or other medications that affect metabolism, and people who recently experienced significant weight change.

Accuracy is also reduced at the extremes of body composition. Very low body fat, very high body fat, unusual lean mass, limb differences, edema, and recent changes in training status can all shift energy needs away from the equation result. Katch-McArdle may help when lean body mass is known, but only if the body fat estimate is reliable.

In medical contexts, formula output should be treated as a rough starting estimate. Actual energy needs are better determined by tracking intake, weight, symptoms, labs, and clinical goals over time under professional supervision. A calculator can organize the first estimate. It cannot monitor safety or make clinical decisions.

Medical nutrition decisions can also involve goals other than weight change. A clinician may prioritize blood glucose stability, kidney function, gastrointestinal tolerance, wound healing, fertility treatment, athletic recovery, or medication timing. Those priorities can change the right calorie target and macro distribution even when the calculator math is correct for a healthy adult.

A medical context also changes the risk of acting on a wrong estimate. For a healthy adult, a 10% calorie error often leads to slower progress or unexpected weight change. For a person using insulin, recovering from surgery, managing kidney disease, or restoring weight after restriction, the same error can affect safety. That difference is why our calculators stay conservative in medical language and direct higher-risk readers to professional care. The same caution applies when symptoms change after a diet, supplement, medication, or training adjustment.

Reporting concerns about content

We prioritize reports about content that may be inaccurate, outdated, or potentially harmful. If you see a safety concern, unsupported claim, or calculation behavior that appears wrong, send the page URL, the exact statement or output, and any supporting source through the Contact page. Concerns about safety or accuracy are reviewed before general feature requests.