Does Exercise Impact Weight Loss?

Yes, of course. But perhaps not as much as you might have been banking on.

The problem: Most of us are painfully sedentary as a result of our jobs and lifestyles. To compound that, most of us have been consuming too many calories in relation to our needs for many years. This means that we are spending less energy than we ever did because we don’t move much, and we’re consuming far more energy than we ever needed historically.

I find that this is a particularly significant issue for women because our energy demand is far less than our male counterparts, but society has been subtly encouraging us to eat the same amount our entire lives. Some people have the “benefit” of a genetic foundation that allows for a substantial amount of compensatory adaptation for this over-calorie-conundrum throughout our childhoods and adulthoods, sometimes breaking down around the same time that our hormones begin to shift in middle-age. Effectively, these individuals are the ones deemed to have a “fast metabolism”. Other people have “thriftier genes” and are more inclined to store excess energy from an early age and are therefore likely to become overweight early on. Believe it or not, “thriftiness” is actually an evolutionary benefit…. but not in the modern western world where just by walking down the street you will probably be bombarded by calories in the form of food advertisements, free samples, dozens of tasty-looking restaurant chains and a lot of misinformation about food.

I think it’s very important to emphasize that it’s NOT all about calories. In fact, I often encourage my weight loss patients not to count them at all. All food is not metabolized equally by the body, and what you eat is certainly an essential part of the equation. I will have to dive into this topic in another blog post at a later date.

Photo by: Toa Heftiba

Photo by: Toa Heftiba

In the mean-time, I want to address the energy-in, energy-out equation. This is where exercise comes in. Even a few centuries ago (and certainly thousands of years ago), we were moving a great deal. Everything we did required physical effort and exertion. Our energy expenditure was much higher. Now, we expend only a fraction of this energy. This directly contradicts the set-up of our biology. Do you have a Fitbit, Apple Watch or step tracker of some kind? Are you hitting your 10,000 steps-per-day minimum for “health”? This number is the agreed upon level of exertion to provide a fair amount of protection against chronic disease. But don’t make the mistake of thinking that this is what would be optimal for our bodies’ and their metabolisms. It is not.

I was sort of annoyed by this TIME article about how our sedentary behavior has little to do with our weight gain because hunter-gatherers have slower metabolisms than us, so their energy requirement is roughly the same even though they are much more active. I find this annoying because…. of course they have slower metabolisms! This is a genetic/adaptive mechanism that allows hunter-gatherers to survive on fewer calories. Meanwhile, our bodies are doing their best to adapt our metabolisms to our high-calorie intake… but are fighting a losing battle.

What is the solution to this disequilibrium?

-Well, increasing your activity level to a minimum of 10,000 steps daily is a really good start because muscular exertion has many benefits beyond calorie expenditure (like supporting blood pressure, insulin function, producing happy hormones, improving lymphatic function, promoting bone density and lowering overall mortality).

-Ideally, having periods during the day where your heart rate increases to target range will ensure that you are putting healthy stress on your cardiovascular system and encouraging use of glycogen stores and then lipolysis.

-Next, you need to heavily consider your caloric intake in general. This can be difficult to track because many of us a) use imperfect diet tracking applications and b) forget about some subtle but profound sources of calories like beverages and added oils.

-Third, you need to consider the source of said calories. 1,500 calories of processed food, high-fat animal products, refined carbohydrates like bagels and muffins and refined oils will NOT impact your body the same way that carrots, asparagus and chickpeas will (random choices to represent unprocessed plant foods as a whole). As a general guideline, avoiding processed foods is essential for supporting a positive shift in your metabolism. Also often neglected is an emphasis on avoiding pesticide and hormone contamination which some individuals are exquisitely sensitive to and cause profound endocrine (hormone) disruption. The former is an issue in non-organic plant foods and both hormones and pesticide residues are an issue with most animal foods.

A “rapid weight loss” treatment plan that I work on with patients at the beginning of one of my programs can sometimes result in a “deer-in-headlights” look because the lifestyle changes I recommend are so darned difficult to do in our modern world. I typically can be found nodding affirmatively when met with this concern. These patients are 100% right. We live in a world where living a healthy life and achieving optimal wellness is in every way more difficult than being unhealthy and overweight. Restaurant menus are designed against us. Our tech-heavy workdays that require very little movement are designed against us. Our modern social rituals full of grazing on processed, fiber-less calories and excessive drinking of sugar-filled liquid calories are designed against us. I mean, really - imagine if in the year 1850 somebody offered you access to a stationary machine in a building they owned that you could walk on all day if you wanted in exchange for a modest chunk of change each month. The very concept of a gym is a great example of how far our daily lives have changed from what the human body was built for.

Photo by: Trust “Tru” Katsande

Photo by: Trust “Tru” Katsande

Achieving optimal weight requires big change in lifestyle. For women, this change is far more challenging than it is for men in the sense that women’s metabolic demand is already much lower than men’s. So to lose weight as a woman, you essentially have to work twice has hard.

But it can be done. Instead of engaging in self-blame and self-deprecation, re-orient your perspective towards understanding how the current culture and environment around you is affecting your decisions and your use of the resources within your body (outlined above) to optimize your energy input/energy output. This will allow you the mental space to motivate yourself and strategize for therapeutic change.

Let me know if I can help.

In Health,

Dr. Otto