Monday 21 August 2023

10 Things People Don’t Understand About Weight Loss

Stop trying to lose weight! If you follow the typical diet & fitness industry approach you will at best get temporary weight loss. However, you will likely gain fat, lose muscle, and harm your healthy in the long run. Let's look at 10 things people just don’t understand about weight loss. It’s time to stop being a repeat customer of the diet industry. It’s time you learn what really works to improve your long-term health and well-being. 

Photo by i yunmai on Unsplash

1. Genetics play a HUGE role in how you look
Celebrities, pro athletes, actors, actresses, physique athletes, and your favorite fitness influences share one thing in common – amazing genetics. While you can, through consistent hard work build muscle and burn body fat, this only goes so far. To have the “look” that our society says is beautiful, requires a rare set of genes. You can use their diets, follow their exercise programs (FYI most of which are not good), work just as hard (or harder), use the same pharmaceutical assistance (please don’t), and you still will not look like these famous “beautiful” people.
 
Application: We are all different. Don’t hold genetic outliers up as your standard. Stop wanting someone else’s body. Never compare yourself to anyone other than yourself (and if you are like most people, you need to be kinder to yourself). Stop worrying about what you can’t change – your genetics, and start focusing on what you can change – your mindset and your habits.

2. Rapid changes in body weight are not changes in body fat 
For well over a century, the diet industry has relied on people failing to realize that there is a difference between weight loss and fat loss. Weight loss is fast and easy. Fat loss is slow and hard. This is why Quacks can sell over those counter detox cleanses – you can easily drop 5-10 pounds of water weight in less than a week on a cleanse. This is why many people fall in love with low-carb diets like Keto. When you cut out carbs, you rapidly lose muscle and liver glycogen. For each gram of glycogen, your body stores 3g of water. Thus, a rapid drop in glycogen (and thus water weight) gives you a rapid drop in scale weight (and a false sense of “success”). As soon as you re-introduce carbs, your body will increase glycogen stores and you will see rapid weight gain (from increased glycogen and water weight – not fat). 

Application: Stop using the scale to measure your progress. You could gain 5lbs of muscle, lose 5lbs and the scale would tell you nothing happened. For some people, weighing leads to an unhealthy body image. I believe it is best for most people to throw out the scale and instead track their accumulation of healthy habits. As you ingrain these healthy habits, your body will naturally adjust to the right spot for you. If you choose to ignore this advice and insist on tracking, then at least track body composition, not just scale weight. If you have access to testing (e.g., DEXA, Bod Pod, Hydrostatic Weighing, a skilled skinfold caliper tester, etc.), great. If not, take some measurements (minimum waist for men and waist and hips for women) to go along with the scale weight. 

3. Popular diets are unnecessarily restrictive ways of creating a calorie deficit 
Here is how all popular diets work. You start by demonizing something that people commonly eat. For vegans, it's animal products. For carnivores, it is all plants. For keto, carbs are your enemy. In other diets, the enemy might be fat, fruit, cooked foods, tomatoes, wheat, gluten, fruit, etc. With intermittent fasting, the enemy is long windows of eating. On the surface, these diets look very different. They all have convincing ambassadors and seemingly compelling reasons why you should go on diets. All these diets shift your focus from what really matters for fat loss – a calorie deficit, to what is less important. Ironically, they all (despite what the “gurus” say) work primarily by the same mechanism – they get you eating less and thus get you into a calorie deficit. 

On one hand, I’m all for finding a way of eating that helps you optimize your health, performance, and body composition. However, most popular diets take nutrition – which is already hard and makes it even harder. You end up following more rules than you need to so you can stay in their exclusive diet club. Yes, this can still “work”, but the more restrictive a diet is, the less likely it is sustainable. Your long-term health and well-being depend on your ability to sustain healthy eating habits. In addition, because of the excessive restriction, these diets can in the long run lead to vitamin and mineral deficiencies. 

4. The common approach to calorie counting doesn’t work
Despite what the diet “gurus” say, calories remain the most significant determinant of fat loss. People who understand this often use calorie counting to help lose weight. However, most people are too inaccurate with their counting to ensure that they are consistently in a calorie deficit. For example, a study on subjects with “diet resistance” compared how many calories subjects reported they were burning and consuming with what they actually burned and consumed. Researchers found that subjects underreported actual food intake by about 47% and over-reported physical activity by about 51% (Lichtman et al., 1992). In addition, you also have issues with food labeling accuracy. According to FDA guidelines, packaged foods are allowed to contain up to 20% more calories than listed on the label. 

Now, you might be saying, “Well that study was over 30 years old. Today we have sophisticated apps to count calories!” Sure, today’s apps speed up the process compared to looking in a book for the calorie amounts of various foods. However, most people guess their portion sizes. “I think that was about a cup of cereal.” As a result, they waste their time doing inaccurate, unhelpful calorie counting. 

Calorie counting has been used very successfully by bodybuilders and other physique athletes. One reason for this is that physique athletes weigh their food. For example, they know how many calories of rice they are eating at a meal because they are eating exactly 100g of rice. In addition, physique athletes usually use calorie counting when dieting down for a show (i.e., they are not trying to do this indefinitely, but for a short period to get ripped to step on stage - and gain back a lot of fat after the show). For the average individual, calorie counting is inaccurate, time-consuming, and unsustainable.

Application: If you are trying to get ripped for a physique show or photoshoot, use calorie counting for the duration of your cutting/prep phase – if you are willing to take the time to use a food scale and weigh your food.  For everyone else, recognize that while calories do count, you do not have to count them. There are many eating habits that will improve your health and reduce your calorie intake (e.g., making water your beverage of choice, emphasizing minimally processed nourishing foods, eating slower, not eating in front of the TV, increasing vegetable intake, increasing protein intake, etc.).

5. Diets don’t work – long term
To lose weight, most people go on a diet. Diets usually work okay in the short term – especially if one is new to dieting. Once people have lost weight on a diet, they are sold. Every time they want to lose weight, they go back on a diet. However, because diets are drastic changes to your way of eating, few people are able to stick to these changes. When the diet is over, they go back to their old habits and quickly regain the weight they lost.
 
In 2020, the British Medical Journal published a meta-analysis (a study that statistically analyzes a bunch of related studies to get a better big-picture view of the research) on diets. They found that in the short term (about 6 months), diets resulted in modest weight loss and some improvements in cardiovascular risk factors. However, by about the 12-month mark, the weight loss and health improvements were pretty much gone. 

We shouldn’t need a meta-analysis to tell us this. We have all seen friends who post before and after weight loss pictures on social media. However, when you see that person 6-12 months later, you notice they have gained most if not all the weight back. 

Application: Stop going on and off diets and seek habit change (more on this to come).

6. Diets leave you worse off than when you started 
Let’s say you decide to go on a diet. After a few months of misery and deprivation, you lose 10 lbs. You feel great. You enjoy the compliments from your friends. However, when the diet is done, you are very hungry. Remember, your body didn’t understand that you were trying to get in shape for the summer. Your body thought it was being starved. When the diet is over, your relationship with food has changed. You are starving and find it harder than ever to control your food cravings. Before long, you have gained back the weight you lost. You feel ashamed and undisciplined. You end up in a worse psychological state than you were before you started your diet.

In addition, most people fail to realize that when you return to your previous weight, you are not at your previous body composition. Unless you are diligent in holding onto muscle, you will lose muscle while you are in a calorie deficit. As a result, when you gain the weight back you now have more fat and less muscle than when you started. 

7. Weight Cycling is Unhealthy
Research shows that weight cycling is associated with numerous adverse health outcomes including increased mortality (Gaesser & Angadi, 2021). Many people who started their weight loss journey to improve their health end up in a futile cycle of losing and re-gaining weight. They get no health benefits. While they have times when their weight is down, they are in the long run gaining fat, losing muscle, and harming their health. Their diets which were supposed to help them lose fat ends up being a very effective method for long-term fat gain.

8. Strength and Muscle are Really Important!
When we think about muscle, we think about getting jacked for the beach, a bodybuilding show, or the football field - not about health. While trying to lose weight end up losing muscle. In addition to impacting your metabolic rate, muscle is really important for your health. Here are some examples of the health benefits of muscle:
  • Muscle independently predicts survival in older adults (Srikanthan & Karlamangla, 2014)
  • Muscle improves glucose update in muscles (Wackerhage et al., 2022)
  • Muscle lowers your risk of type 2 diabetes (Wackerhage et al., 2022, Jun et al., 2023)
  • Muscle is significantly associated with maintaining metabolic health (Lee et al., 2019)
  • Muscle reduces the mortality risk of cardiovascular disease, cancer, and respiratory disease (Lee et al., 2018)
  • Muscle reduces functional impairment and physical disability (Janssen et al., 2002)
  • Low muscle increases your risk for all-cause mortality (and CVD) (Zhang et al., 2022)
  • Low muscle associated with cognitive decline (Tessier et al., 2022)
Strength is also important for health. Many people don’t realize that grip strength (which is often used in research as it correlates to overall body strength) is associated with long-term mortality risk - and that this risk is independent of BMI (body mass index) (Rantanen et al., 2000). In addition, muscle and strength seem to make your body more resilient to illness. Researchers assessed the grip strength and measured the quad mass of 186 patients who were admitted to the hospital with covid. Those with a stronger grip got out of the hospital sooner and those with the smallest quads were in there longer (Gil et al., 2021).

Application: Everyone over 30 should be trying to build or at least maintain muscle (and this gets more important as you age). If you are trying to lose body fat, you want to make sure that try to hold onto as much muscle as possible. Do resistance training at least twice a week that emphasizes your best exercises for the Big-6 movements. In addition, make aim to get about 1g of protein per pound of ideal body weight. 

9. Improving fitness is more important than weight loss
Many people seek weight loss to improve their health or to help prevent health problems. Ironically, they fail to realize that cardiovascular fitness is more important. A 2014 meta-analysis compared fitness vs. fatness on all-cause mortality. The researchers found that unfit people had twice the mortality risk of fit individuals, regardless of their BMI. They also noted that overweight & obese people who were fit had similar mortality risks as “normal weight” fit people (Barry et al., 2014). Another systematic review and meta-analysis found that exercise improves cardiometabolic health in overweight or obese adults (Battista et al., 2021). Research shows that the mortality risk of obesity is largely reduced or eliminated with moderate-to-high levels of cardio fitness. It also shows that weight loss is not consistently associated with lower mortality risk. However, increases in fitness and physical activity are consistently associated with greater reductions in mortality risk than weight loss (Gaesser & Angadi, 2021).

Application: After getting medical clearance, start moving. This can be something as simple as a short walk. Try different modes (e.g., cycling, walking, swimming, and various cardio machines) to see what you enjoy, what is practical, and what feels best on your body. Start with whatever you can handle. Gradually increase your time and intensity to build yourself up to a moderate level of fitness. High levels of fitness are great for performance, but not necessary for health (Stofan et al., 1998). Check out this website for ideas on practical aerobic testing options so you can know your fitness level. 

10. Healthy habits lead to better long-term health
Ironically many people go on a diet to improve their health, yet end up using methods that harm their health. Instead of becoming another repeat customer of the diet industry and another depressing diet stat, I encourage you to take a different approach. Everyone’s body is the way it is because of their genetics and their habits. Since you can’t change your genetics, focus instead on what you can change – your habits. 

Even the healthiest actions are not helpful if you cannot sustain them. Only sustainable habit changes lead to sustainable change. Stop trying to change everything all at once. Instead, pick one simple healthy practice. Make it small and simple. For example, if you don’t do any strength training, start with just one set of one exercise. If you need more sleep, start by adding 15 minutes. If you don’t walk, start with just a few minutes per day. Once you are doing that practice consistently, you can add to it. Stay with that and practice it until it is a habit (i.e., a normal part of your day). Then, pick another habit and repeat the process. No, this approach will not have you ripped by the end of the month (note: if most people knew how much work and sacrifice it takes to get ripped, they would pass). You might never look like a movie star or a fitness model. However, in the long run, you will be healthy and flourishing.

For more ideas on healthy habits, check out this article.

References

Barry, V. W., Baruth, M., Beets, M. W., Durstine, J. L., Liu, J., & Blair, S. N. (2014). Fitness vs. fatness on all-cause mortality: a meta-analysis. Progress in cardiovascular diseases, 56(4), 382–390. https://doi.org/10.1016/j.pcad.2013.09.002

Battista, F., Ermolao, A., van Baak, M. A., Beaulieu, K., Blundell, J. E., Busetto, L., Carraça, E. V., Encantado, J., Dicker, D., Farpour-Lambert, N., Pramono, A., Bellicha, A., & Oppert, J. M. (2021). Effect of exercise on cardiometabolic health of adults with overweight or obesity: Focus on blood pressure, insulin resistance, and intrahepatic fat-A systematic review and meta-analysis. Obesity reviews : an official journal of the International Association for the Study of Obesity, 22 Suppl 4(Suppl 4), e13269. https://doi.org/10.1111/obr.13269

Code of Federal Regulations: 21 CFR 101.9 - Nutrition labeling of food (g)(5).

Gaesser, G. A., & Angadi, S. S. (2021). Obesity treatment: Weight loss versus increasing fitness and physical activity for reducing health risks. IScience, 102995. https://doi.org/10.1016/j.isci.2021.102995

Ge, L., Sadeghirad, B., Ball, J.D.C., da Costa, B.R., Hitchcock, C.L., Svendrovski, A., Kiflen, R., Quadri, K., Kwon, H.Y., Karamouzian, M., Adams-Webber, T., Ahmed, W., Damanhoury, S., Zeraatkar, D., Nikolakopoulou, A., Tsuyuki, R.T., Tian, J., Yang, K., Guyatt, G.H., & Johnston, B.C. (2020). Comparison of dietary macronutrient patterns of 14 popular named dietary programmes for weight and cardiovascular risk factor reduction in adults: systematic review and network meta-analysis of randomised trials. BMJ (Clinical Research Ed.), 369:m696. doi: 10.1136/bmj.m696.

Gil, S., Jacob Filho, W., Shinjo, S. K., Ferriolli, E., Busse, A. L., Avelino-Silva, T. J., Longobardi, I., de Oliveira Júnior, G. N., Swinton, P., Gualano, B., Roschel, H., & HCFMUSP COVID-19 Study Group (2021). Muscle strength and muscle mass as predictors of hospital length of stay in patients with moderate to severe COVID-19: a prospective observational study. Journal of cachexia, sarcopenia and muscle, 12(6), 1871–1878. https://doi.org/10.1002/jcsm.12789

Janssen, I., Heymsfield, S. B., & Ross, R. (2002). Low relative skeletal muscle mass (sarcopenia) in older persons is associated with functional impairment and physical disability. Journal of the American Geriatrics Society, 50(5), 889–896. https://doi.org/10.1046/j.1532-5415.2002.50216.x

Jun, J. E., Lee, S. E., Lee, Y. B., Kim, G., Jin, S. M., Jee, J. H., & Kim, J. H. (2023). Low Skeletal Muscle Mass Accompanied by Abdominal Obesity Additively Increases the Risk of Incident Type 2 Diabetes. The Journal of clinical endocrinology and metabolism, 108(5), 1173–1180. https://doi.org/10.1210/clinem/dgac662

Lee, D. H., Keum, N., Hu, F. B., Orav, E. J., Rimm, E. B., Willett, W. C., & Giovannucci, E. L. (2018). Predicted lean body mass, fat mass, and all cause and cause specific mortality in men: prospective US cohort study. BMJ (Clinical research ed.), 362, k2575. https://doi.org/10.1136/bmj.k2575

Lee, M. J., Kim, E. H., Bae, S. J., Choe, J., Jung, C. H., Lee, W. J., & Kim, H. K. (2019). Protective role of skeletal muscle mass against progression from metabolically healthy to unhealthy phenotype. Clinical endocrinology, 90(1), 102–113. https://doi.org/10.1111/cen.13874

Tessier, A. J., Wing, S. S., Rahme, E., Morais, J. A., & Chevalier, S. (2022). Association of Low Muscle Mass With Cognitive Function During a 3-Year Follow-up Among Adults Aged 65 to 86 Years in the Canadian Longitudinal Study on Aging. JAMA network open, 5(7), e2219926. https://doi.org/10.1001/jamanetworkopen.2022.19926

Rantanen, T., Harris, T., Leveille, S. G., Visser, M., Foley, D., Masaki, K., & Guralnik, J. M. (2000). Muscle strength and body mass index as long-term predictors of mortality in initially healthy men. The journals of gerontology. Series A, Biological sciences and medical sciences, 55(3), M168–M173. https://doi.org/10.1093/gerona/55.3.m168

Srikanthan, P., & Karlamangla, A. S. (2014). Muscle mass index as a predictor of longevity in older adults. The American journal of medicine, 127(6), 547–553. https://doi.org/10.1016/j.amjmed.2014.02.007

Stofan, J. R., DiPietro, L., Davis, D., Kohl, H. W., 3rd, & Blair, S. N. (1998). Physical activity patterns associated with cardiorespiratory fitness and reduced mortality: the Aerobics Center Longitudinal Study. American journal of public health, 88(12), 1807–1813. https://doi.org/10.2105/ajph.88.12.1807

Wackerhage, H., Vechetti, I. J., Baumert, P., Gehlert, S., Becker, L., Jaspers, R. T., & de Angelis, M. H. (2022). Does a Hypertrophying Muscle Fibre Reprogramme its Metabolism Similar to a Cancer Cell?. Sports medicine (Auckland, N.Z.), 10.1007/s40279-022-01676-1. Advance online publication. https://doi.org/10.1007/s40279-022-01676-1

Zhang, D., Spiropoulos, K. A., Wijayabahu, A., Christou, D. D., Karanth, S. D., Anton, S. D., Leeuwenburgh, C., Liang, M., Wheeler, M., Yang, D., Livingstone, A. P., Mankowski, R. T., Cheng, T. D., Zhang, H., Siegel, E. M., Penedo, F. J., Licht, J. D., & Braithwaite, D. (2022). Low muscle mass is associated with a higher risk of all-cause and cardiovascular disease-specific mortality in cancer survivors. Nutrition (Burbank, Los Angeles County, Calif.), 107, 111934. Advance online publication. https://doi.org/10.1016/j.nut.2022.111934


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