The Role of Exercise in Weight Loss

Mathematically you can design an exercise schedule for yourself that burns enough calories to lose 1 to 2 pounds a week. While this works on paper, the level of exercise commitment such a regimen requires is not sustainable for the vast majority of people, especially if it is started all at once. Several panels of experts have looked at all of the evidence and reached the conclusion that while exercise is extremely important, it does not lead to significant weight loss on its own.

This does not mean that it is a waste of time to exercise. Exercise is one of the healthiest things that you can do for yourself. Even a moderate activity like walking for thirty minutes every day at a comfortable pace will burn an additional 200 calories. True, this is not enough activity to cause a dramatic drop in your weight, but it will give your weight loss a boost. Additionally, the few hundred calories that are burned with regular physical activity compensate for adding a bit more food to the eating plan during weight loss. That can make the difference between a diet that feels as if it’s depriving and a weight-loss program that is livable.

It is important to have realistic expectations about what exercise can and cannot do for weight loss. During the early days and weeks of weight loss, scheduling exercise is a way to help organize the day. About 200 to 300 calories burned during exercise can give weight loss a bit of a push. Exercise also helps boost mood and helps control stress, as noted earlier in the chapter. At a time when living a healthier lifestyle is foremost in your mind, physical activity can be a bright spot in the day.

So watch out for the trap in thinking that exercise alone will be enough for weight loss—that is a setup for disappointment. People who expect a lot of weight loss from exercise alone may become so discouraged that they give up their goal of losing weight or stop exercising altogether.

Weight Gain Is Also Due to Overeating

While reduced physical activity is a significant contributor to weight gain, we are also eating more. The average American adult eats about 300 more calories per day than in 1970. In studies that have looked at where those calories are coming from, mixed grain dishes like pizza and tacos and calorie-containing beverages except milk top the list.

Experts agree – the combination of eating more and moving less is behind the weight gain of the past thirty years.

Weight loss and weight gain are explained by the balance between calories in and calories out. You gain weight if you take in more calories than you burn, and you lose weight if you burn more calories than you take in.

To lose 1 pound, you need to create a calorie deficit of 3,500 calories. Over a week, this translates into 500 calories a day. You can create this calorie deficit through a combination of increased physical activity and cutting back on food. But how much can exercise contribute? Can it be an effective stand-alone weight-loss solution?

Exercise alone as a weight-loss method is particularly ineffective without

paying attention to food intake, and increasing activity is not a free pass to ignore eating habits. People who begin an exercise program often overlook the food side of the calories in/calories out equation. Some people even increase the amount of food they eat because they think they are burning more calories than they really are. The end result – weight gain rather than weight loss!

Going to the gym without a similar effort on the food front is sure to backfire.

Numerous research studies show that it is common for people who are trying to lose weight to overestimate their physical activity—they think that they worked longer and harder than they really did. People also underestimate the amount of food or calories they are eating. So the difference between calories in from food and calories out from exercise is smaller than they think. It is all too easy to overeat any time spent in exercise. For example, it takes about an hour on the treadmill for a 170-pound man to burn off a medium-size bagel (without butter or cream cheese), a few cookies, or a donut. A 150-pound woman doing a 30-minute workout at a circuit training gym like Curves burns about 150 calories, or the equivalent of a 12-ounce glass of orange juice. That’s not a lot of food.

A Closer Look at Weight and the Metabolic Syndrome and Cancer

Many people have never even heard of the metabolic syndrome, cancer also known as Syndrome X. Until recently, most physicians had never heard of the

metabolic syndrome either. Yet this condition – a combination  of blood lipid abnormalities, high blood pressure, and elevated blood sugar—affects almost one-quarter of the adult population in the United States. The major underlying cause of the metabolic syndrome is obesity, in particular, increased abdominal fat.

Five different conditions make up the metabolic syndrome:

1. High blood triglycerides

2. Low HDL cholesterol

3. High blood pressure

4. Elevated blood sugar

5. Increased waist circumference (as mentioned earlier in this chapter, greater than 40 inches in men and greater than 35 inches in women)

The metabolic syndrome is rapidly becoming a significant medical problem because it increases so many risk factors for heart disease and diabetes. Weight loss is the only effective treatment for this condition.

Do those extra few pounds really matter?

As weight goes out of the healthy range, risk increases for

• Heart disease
• High blood pressure
• Stroke
• Diabetes
• Several forms of cancer
• Metabolic syndrome (Syndrome X)
• Gallbladder disease
• Gout

A Closer Look at Weight and Cancer

Recent studies from the National Cancer Institute and other research institutions suggest that over 20% of all cancer is related to overweight or obesity. For years, researchers have commented that certain forms of cancer with a link to hormones (for example, breast and endometrial cancer in women, prostate cancer in men) are associated with weight gain, overweight, and obesity. As summarized in a government report on overweight and obesity, obesity increases the risk of breast cancer after menopause because body fat produces the hormone estrogen. Even weight gain not to the point of obesity can be a problem: gaining more than 20 pounds between age 18 and midlife doubles a woman’s breast cancer risk. The risk of colon cancer and other gastrointestinal tract cancers that do not appear to have a connection to hormones also goes up as one’s weight increases.

A Closer Look at Over Weight and Diabetes

Perhaps the strongest association between weight gain, metabolic abnormalities, and disease risk is found with type 2 diabetes. (Type 1 diabetes typically affects younger people and is caused by the pancreas not producing insulin.) A majority of people who have type 2 diabetes are also overweight, and the incidence of type 2 diabetes is increasing as the population becomes more overweight.

About 90% of people with diabetes have type II diabetes, which develops when the insulin-producing pancreas cannot keep up with the body’s need for insulin, a hormone that helps blood sugar enter cells. With weight gain, cells in the body do not respond properly to insulin, causing an unhealthy rise in blood sugar levels. This is known as insulin resistance. The pancreas produces insulin, but the insulin no longer works effectively.

Weight gain dramatically increases diabetes risk. The risk goes up with weight increases after age 18. The risk also increases about 25% for every unit increase in BMI over 22. One study estimated that more than one-quarter of new cases of type 2 diabetes could be attributed to a weight gain of 11 pounds or more. If we eliminate adult weight gain and obesity, we could eliminate over 80% of all type 2 diabetes. It is not surprising that one of the first treatment recommendations for type 2 diabetes is to lose weight.

The link between weight loss and diabetes prevention is particularly compelling. In the Diabetes Prevention Program, a lifestyle program that was conducted at several research institutions and included weight loss and physical activity components, participants dramatically reduced their risk of developing diabetes with a weight loss of just 7%. The results of this lifestyle program were similar to those observed in people on medication.

A Closer Look at Weight and Heart Disease

Heart disease is the leading killer of both men and women; 54% of all deaths result from heart disease. Being overweight or obese or having too much abdominal fat are strongly associated with heart disease risk factors including an increase in total and LDL (“bad”) cholesterol, triglycerides, and blood pressure. Overweight, obesity, and abdominal fat increase the risk of diabetes, which is a heart disease risk factor.

Being overweight also directly affects risk of heart disease – if your BMI is in the overweight range, your heart disease risk doubles compared to people with BMIs in the healthy weight range. If your BMI is in the obese category, your heart disease risk quadruples. Losing weight reduces the risk of heart disease.

A Closer Look at Weight and High Blood Pressure

If we could eliminate overweight and obesity in our country, we could eliminate between 40% and 70% of the medical diagnoses of high blood pressure. Societies where people don’t gain much weight as they get older do not experience this increase in high blood pressure. The first thing a doctor tells an overweight or obese patient who has high blood pressure is to lose weight. Often this is enough to get his or her blood pressure under control even without any blood pressure medication.

A Closer Look at Weight and Other Cardiovascular Problems

Increased weight is associated with increased risk of congestive heart failure, a frequent complication of obesity and a major cause of death. Obesity changes the heart size and structure, preventing it from working properly.

Obesity also dramatically increases the risk of ischemic stroke, which is like a heart attack that happens in the brain. Compared to a woman with a BMI in the healthy range, a woman with a BMI greater than 27 has a 75% higher risk of ischemic stroke, and a woman with a BMI greater than 32 has a 137% higher risk. Losing weight helps reduce the risk of both of these problems.

Increased weight negatively affects cholesterol levels in the body, as well as some of the components of cholesterol. Your total cholesterol level is made up of three different types of cholesterol: LDL (“bad” cholesterol), VLDL (a mixture of triglycerides and cholesterol), and HDL (“good” cholesterol). Each type of cholesterol has a different function. For heart health, the goal is to decrease LDL cholesterol and increase HDL cholesterol, since LDL contributes to heart disease risk and HDL helps protect the heart. Increased weight creates problems by increasing LDL levels and decreasing HDL levels. It also drives up triglycerides, another type of fat in the blood. Weight loss improves the blood cholesterol and triglyceride levels.

TARGET CHOLESTEROL LEVELS

What It Stands For Levels to Aim For (mg/dL)

TG Triglyceride Lower than 150

LDL Low-density lipoprotein Lower than 100 is optimal; greater than 160 is high

HDL High-density lipoprotein Greater than 40

Is your body shaped more like an apple or a pear? When it comes to weight and health, being shaped like an apple carries greater health risks than being shaped like a pear.

You are apple-shaped if your body fat has settled around your belly. Men are genetically predisposed to gain weight around their belly, although there are exceptions. Having an apple-shaped body means that you have too much abdominal fat. Abdominal fat increases your risk of heart disease, diabetes, and breast cancer following menopause.

Pear-shaped bodies store more fat in the buttocks and hips. Women tend to gain weight on the hips and thighs. Whatever your shape, however, BMI is still important because it is linked with overall body fat. Chances are, if your BMI is high, your waist circumference will be high too.

How to Evaluate Your Abdominal Fat

• Using a cloth measuring tape, like the one used by tailors, measure around the widest area between your belly button and the top of your hips.
• For men, if this measurement is more than 40 inches, you have abdominal obesity.
• For women, if this measurement is more than 35 inches, you have abdominal obesity.

You can lose weight with exercise alone?

Nobody is going to tell you that exercise is not a good thing. It offers many health benefits – better sleep, reduced stress, improved strength and muscle tone, and it puts you in a better mood. It also burns calories. So it makes sense that increasing physical activity be part of the weight-loss formula. But exercise as a weight-loss method has limitations. This chapter explores the effectiveness of exercise and its role in weight loss and maintenance.

Most diets fail because they focus on the wrong thing. Successful weight loss is not really about food; it is about exercise. The main focus of a weight-loss effort should be exercise because it will make the pounds come off faster and the loss will be maintained. With all the technological changes in our daily lives, most of us are not getting enough exercise. People, especially guys, start gaining weight in their late 20s, then continue to gain weight into their 30s and 40s as work and family take up more of their time. With less time to exercise and be active, of course they gain weight. So it makes sense that getting back into exercise will melt away the pounds. The commitment to exercise is not very demanding. Getting to the gym just a few times a week will make a huge difference in weight loss. And the more time spent at the gym, the faster the pounds will come off. It should take only a couple of hours a week for the next two or three months to lose the weight that has accumulated over the past ten or so years. Going to the gym tones the body, flattens the stomach, and firms the thighs. It changes the shape of the body. Losing weight through dieting can’t do that. So even if the pounds on the scale stay the same, that is okay; it just means that the fat is turning into muscle. The amount and intensity of activity determines its health benefits.

Moderate-intensity exercise is recommended for weight loss and also improves your cardiovascular fitness. High-intensity exercise performed continuously for at least twenty minutes is recommended mainly for heart fitness. People who are more than 30 pounds overweight should not exercise at an intense level without talking to a doctor. Light activity burns only a modest amount of calories but offers numerous benefits. It generally does not burn enough calories to aid weight loss unless it is performed for a long period of time.

The Link between Weight and Health

Weight and health are strongly related to each other. Disease risk goes up slowly as weight gain pushes you out of the healthy weight range and into the o

verweight range. Your risk of disease and death increase significantly if extra weight puts you in the obese range. One study reported that obesity in middle age reduces life expectancy by seven years. The list of weight-related diseases continues to grow. Increased weight raises blood lipids (cholesterol and triglycerides) and blood pressure, which are heart disease risk factors. Weight gain impairs the body’s ability to handle glucose (blood sugar) and contributes to a pre-diabetic condition called insulin resistance. Other medical conditions that are associated with increased weight include certain cancers, osteoarthritis of the knees and other weight-bearing joints, gastrointestinal tract disturbances, interrupted sleep and sleep apnea, and reduced fertility. To date, obesity has been linked with more than thirty medical conditions.

It is not just big gains that carry ill health effects—the consequences of gradual or modest weight gain add up quickly. Even 10 or 20 extra pounds increases the risk of death among adults, as shown in a large study published in the New England Journal of Medicine. A recently published study found that just a 5% increase in the BMI over time had a negative impact on simple body functions like walking. Research on women, weight gain, and cancer found that women who gained 21 to 30 pounds since age 18 and were not on hormone replacement therapy were 40% more likely to get breast cancer than women who had gained no more than 5 pounds. The risk increased as the women’s weight increased. Similarly, another study found an 8% increase in the risk of postmenopausal breast cancer for every 11 pounds gained.

DO THOSE EXTRA FEW POUNDS REALLY MATTER?

As weight goes out of the healthy range, risk increases for

• Heart disease
• High blood pressure
• Stroke
• Diabetes
• Several forms of cancer
• Metabolic syndrome (Syndrome X)
• Gallbladder disease
• Gout

Understanding Weight Loss

BMI (Body Mass Index) Demystified

Before getting into the whole truth, let’s explain a term that will help you better understand weight and weight loss: Body Mass Index (BMI). BMI is the standard used around the world to determine whether a person’s weight is healthy, overweight, or obese. For most people, BMI is strongly related to the amount of body fat you carry. You could calculate your BMI using your body weight, your height, and the BMI formula, but it is far easier to look up your BMI on a chart like the one below. To determine your BMI category, find your height in inches in the column on the left, run your finger across to the range that includes your current weight in pounds, then look up to the top of that column for your BMI range and category. This chart applies to both women and men.

Body Mass Index and Weight Classification

The path to sustainable weight loss needs a beginning. As you put your new knowledge to work and embark on a comprehensive weight-loss method, there are several things you can do. The goal is to maximize your knowledge so that you are prepared to make informed decisions for your best approach.

• Consult with your doctor before starting any weight management program. It is a good idea to get a complete physical before beginning a diet and/or exercise program to rule out medical limitations.
• Ask your doctor or pharmacist if any of the medications that you’re taking might affect your weight-loss success by increasing your appetite or slowing your metabolism. The good news is that in almost all cases other drugs are available that treat the same condition but do not affect weight. It is worth finding out whether a simple change in your medication can remove this potential obstacle.
• Think about weight-loss methods that you have used in the past.
• How many of the factors that predict successful weight loss and sustained weight loss were part of these methods? Are there things that you could have done differently to include more factors?
• What do you see as your “happy” weight and when do you see yourself achieving it? If your answer is a weight that is less than 90% of your current body weight and your time frame for reaching that weight is in less than six months, rethink your expectations. A reasonable goal is a loss of 10% of your current weight over six months. Start with that goal you may very well surprise yourself by exceeding it!
• Identify at least three people you know who have successfully lost weight and are keeping it off. Find out about their experience what method they used, what strategies and approaches they took to make it work for them, and what they are doing to sustain the weight loss. Compare what they tell you about the factors of successful weight loss, the factors for sustained weight loss, and the basic components of a weight-loss program.
• Remind yourself often and with confidence that sustained weight loss is possible. Your body will not undermine your achievements by slowing metabolism so that you gain the weight back.

Do those extra few pounds really matter?

A large number of us gains weights each year. In fact, adding pounds as we add years is so commonplace that we’ve come to accept it as a natural part of the aging process. We have also come to expect that we are likely to develop common health problems, like high blood pressure and diabetes. Consider for a moment, however, how these extra few pounds may be increasing your risk for developing these medical conditions. Read on to learn why a few extra pounds do matter, how you can halt the gain, and how losing a little pays back a lot