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I’ve been working out 4 hours per week for 6 weeks and have not lost a single pound.

When people decide they need to lose weight, they start by hitting the gym, and 4-8 weeks later they are often disappointed. The letdown leads them to abandon their new routine. 6 months later they are trying a new exercise regime with a similar fate. This cycle has nothing to do with doing exercise correctly or optimally but rather with misconceptions surrounding the role of exercise in weight regulation as well as establishing the wrong motivational base to get active. We should not judge our workout routines by looking at our weight. Let’s take a look at 7 evidenced based statements that help us understand how physical activity properly relates to our weight.


1. There is huge variability is how your weight will react to increased activity

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In the above study they had male and female participants exercise 5 times a week for 10 months burning 400 calories each session without changing their diet. The researchers strictly controlled the amount of exercise.  There was a wide variability observed in weight between participants, particularly in men. Some participants lost impressive amount of weight while others gained weight. Why do Individuals respond differently? Its likely due to genetic, hormonal, metabolic, and even microbiota differences.


2. Exercise on average will help you lose about 3-5 lbs over 18 months

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In the above study, people who excised approximately 4 hours per week only lost a total of about 3 lbs over 18 months. In a meta-analysis looking at 18 large studies, weight loss was only 2.6 lbs greater for the diet-plus-exercise group than the diet-only group.  These statistics may sound depressing but only if you value exercise and activity as a weight loss activity — which you should not.


3. Exercise is one of the best strategies to maintain your weight

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Only 25% of people who lose 10% or more of their weight keep it off.  What separates people who maintain their weight loss? There are lot factors that play a role (a topic to explore in another article) but one major factor is physical activity. As shown in the graph, people who lost >10% of their weight and keep it off were active for at least 200 minutes /week ( averaging 250 minutes /week). As shown below, the best strategy is to gradually built up your physical activity over 6 months and then sustain that activity going forward.

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4. If you were overweight or obese and lost weight–you are at a 60% disadvantage when it comes to maintaining your weight

Studies suggest that normal weight adults need about 150 minutes/week of moderate-intensity physical activity to prevent significant weight gain. However, if you were overweight or obese and have lost weight, you actually need 250+ minutes/week to prevent weight re-gain. Yes that is 60-70% more activity and it’s not easy to do. This likely has to do with the changes that happen at a hormonal, metabolic, and cellular level when you have excess fat. My hope is that we will eventually be  able to target these pathways to give people who have lost weight a fair playing field.


5.The intensity of the exercise does not impact weight

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How hard should you work out? It’s actually the duration or amount of time you work out that matters when it comes to maintaining your weight. Does this mean you can simply get on a treadmill and walk at medium pace while watching TV rather than doing more vigorous exercise? Yes- if your primary intention is weight maintenance.  However, the intensity of weight does play a positive role in decreasing your cardiovascular risk, controlling your diabetes, treating your depression, and decreasing stress. So ultimately you should consult your doctor about which type of exercise is best to manage your overall health and goals.


6. Physical activity can be done in small spurts

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A study published in 1999 showed that people can make small changes to their daily routines that match 45 minutes of exercise 3 times a week (or 135 minutes per week). In this study, one group of women(the lifestyle group) were instructed to
  1. Walk instead of drive small distances (less than 0.3 miles).
  2. Always take the Stairs.
  3. Park in the farthest parking spot from stores.

Another group of women(the aerobic group) were placed in an aerobics class for 45 minutes 3 times a week.  At the end of 16 weeks, both groups lost the same weight. 

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7. Physical activity is the best medicine

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Exercise has been shown to help treat and manage a range of health conditions. If exercise was a drug, it would likely have one of the best outcome to side-effect ratios. A study this past year showed that a sedentary lifestyle may actually confer twice the risk of death as being obese. So it is time to detach our physical activity goals from our weight goals. Find a way to be active that becomes part of who you are. Doing so will do far more for your health than your weight will tell you.

Posted by:Dr. Rami Bailony

Dr. Bailony completed his medical school and internal medicine training from UCSF. Thereafter, he went on to complete a fellowship in Healthcare Innovation with Medicine X at Stanford University where he focused on behavioral change, obesity and diabetes management. From there he went on to co-found Enara Health and Enara Health Group which uses online and mobile platforms to provide clinical programs for obesity and type II diabetes.

One thought on “Exercise and Weight Loss: Time For A Divorce?

  1. This is absolutely the best idea regarding exercise and weight loss I have ever come across. Getting your body parts moving again feels good when you have been sedentary for whatever reason. It is adding to the healthy way my body is starting to feel again. This is the first time losing weight I have wanted to exercise as rehabilitation for injury not thinking about doing it to loose weight. I have found, therefore, joy in being able to move through the day with less pain, the joy of taking a slow paced walk on the trails … even attempting a short bike ride pain free because of taking steps not to further inflame injury but doing enough to start to get in touch with my body again. There seems to have been a disconnect between my body and my brain when I gained this last 60 lbs. Losing 20ish pounds and beginning slowly to move (hot water swimming/back and joint therapy started me on this track. But I have written this lesson down as it really hit home for me…eat healthy and wise to nourish your body exercise for the joy and blessing you are able to do it! Thanks again for sharing this concept!

    Like

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