Can you exercise your way to a lower weight?

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Hey friends!  Back in April I had just returned from “doctor college” in San Diego and I intend to share bits of what I learned there.  Previous posts in this vein have been:

This post is about exercise and weight loss.  Specifically:  Is exercise an effective way to lose weight?

Hmmm . . . . donuts.

Anybody else have a somewhat idle piece of exercise equipment in your house?  The picture at the top of this post is my actual basement treadmill.  On the plus side, it is a terrific place to hang shirts while ironing.  On the negative side, I’m delinquent in my ironing duties.

It is a pretty rare bird indeed who doesn’t sometimes want to lose some weight.  I’m in this group.  Although I’m a rather skinny, lanky guy – I do have that bit of a gut that hangs out more than I’d like.  And I’m a runner, at least much of the time, so I’m thinking . . . WHAT GIVES?  How can I exercise as much as I do and still have weight in places I don’t want it?

I have been told it is not a dearth of exercise that is leading to a big belly, but it is an abundance of donuts.

And who am I kidding, if there is anything that ought to be in abundance, it’s donuts, I say.

Eat less, Move more

I have often relied on this phrase to sum up my advice to people about weight loss.  it is pithy and makes sense.  If you have to lose weight, you simply have to take in fewer calories than your burn.  It’s simple physics.  Eat less, move more.

When I tell people this, I usually launch into my sermon of ways in which we eat poorly:

  • Portion size.  There is no way on God’s green earth that the size of the soda at the movie theater is good or normal or OK in any way.  Or the popcorn.  Or the huge platters of food at the big restaurants.
  • Calories.  I always say eat fewer calories.  We eat too much!
  • Types of calories.  Traditional wisdom says that we should cut back on saturated fats and carbohydrates.  That, too, makes sense.

The truth is that the actual proven science behind what we eat isn’t so clear cut.  My advice to “Eat less” is good, I think, but it is not the whole story.  We need to take in fewer calories, eat more of the healthy foods, and less far less of it.  And eating a diet more reliant on plants is probably good for us and also the planet.  But beyond that, there is very little evidence that one “diet” is better than another “diet” when weight loss is the goal. That being said, paying attention to what you eat is the most important first step in weight loss.

For more of my thoughts on diet and weight, check out these previous posts I wrote:

I eat too much butter: motivating for healthier living

Just a spoonful of sugar . . . is really not good for you

 

So what about exercising the weight off?

Given the challenges in losing weight with diet and food alone, lots of us look to exercise to lose those extra pounds.  But does it really work?

This is what I learned at doctor school in San Diego this spring:

Short answer:  you can’t count on exercise alone to lose weight.  What really matters when you are trying to lose weight is to focus on your diet.  Simply starting an exercise program without changing your diet will not be sufficient for most people.

Longer answer:  exercise is an important part of long-term weight loss maintenance and overall fitness.

Photo: PH Kenny

No, that’s not me in the picture.

But it is my problem, I think.  When I am at a weight I like, exercise is a good way to stay there.  Going for a run 3 or 4 days a week for a few miles each time not only keeps me happy and fit, but it puts my body in a good balance of calories in = calories out and so I stay about the same weight.

But when I get lazy and stop exercising 3 or 4 days a week but continue eating donuts and beer, my weight goes up about 10 pounds.  And it shows up right where I don’t want it:  the belly.  So exercise helps me maintain a healthy weight.

Take home point:  once I’ve put on those 10 pounds, I do need to start exercising more, but more importantly, I need to alter my diet.

Summary:  

  • Diet + exercise = weight loss.  
  • Exercise alone = weight maintenance.

Sure, it’s an oversimplification.  Being overweight (Body Mass Index, or BMI > 25) or obese (BMI > 30) is complicated with many ways to address it (diet, exercise, medications, surgery for some).  But as for exercise: keep it up to maintain a healthy weight, and couple it with dietary changes to lose weight.

Oh, and here’s a good thing to do:  find out your BMI with this BMI calculator from HCMC.

For a lot more about diet, exercise, and weight loss, you may wish to check out “What works well for weight loss” from the American College of Physicians.

Some of this is just common sense.  But given the overwhelming amount of stuff we hear in the media, online, and anecdotally from our friends and neighbors, it’s tough to know what is good advice.  And so if anyone tells you that you simply need to exercise and you’ll lose weight, without also telling you to change your diet, you may be disappointed.  That’s the real advice!

-David

 

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5 Responses to Can you exercise your way to a lower weight?

  1. Dick Felstul says:

    thanks for your blog and your show, it is great info. I am a healthy 66 yr old male. why do I have pain and weakness in my dominant right arm taking a gallon of milk out of the fridge. what exercise can I do to strengthen my arm and reduce pain. thank you

  2. David Hilden, MD MPH says:

    Hi, Dick. I’m sorry I can’t really say what is going on with your arm, but sounds like a nerve problem which could be anywhere from your neck all the way down the arm. Could be a vascular problem as well. So either of those would need medical attention. Or it could be a tendinitis or other musculo-skeletal problem. Lots of possibilities! I’d see a primary doctor or a neurologist to figure it out, maybe a physical therapist could help. As always, I can’t give specific medical advice so this is just general guidance so don’t rely on my short comments here – really should be seen by a doctor. Thanks for listening and checking out the blog.

  3. Dick Felstul says:

    thank you for your response

  4. jeif says:

    Hlw Dr. David, I don’t know how should I complement your writing. Its not like the regular boring one. I really enjoyed while reading it. Currently I’m seriously concerned about my overweight. I cut suger and fast foods and have started yoga and doing qi gong. Do you think they can help?

  5. David Hilden, MD MPH says:

    Thanks, Jeif for the nice words. I’m sorry I can’t give specific advice online about your (very legitimate!) concerns. Keep eating right, exercising, and maybe see your primary doctor!

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