For decades, physicians and skinny friends alike have offered the over simplified, demeaning and flat out wrong advice: eat less and exercise more. If things were this simple, obesity would be a temporary annoyance, not a life threatening, crippling disease. First, as you’ve learned so far, how much you eat is not nearly as important as what you eat. Now, we’ll discuss the very limited role that exercise plays in your long term weight loss goals. Patients frequently complain that they’re unable to lose weight because of an orthopedic problem that limits their ability to exercise. This is simply not true as weight loss is almost entirely dependent on your food intake, not on the amount that you exercise. There are exceptions to this rule that we’ll discuss later, but for the most part, exercise is neither necessary nor important for you to meet your weight loss goals. Nonetheless, there are some very good reasons that you should participate in a structured exercise program, and for many it may be a critical component of your success, but not for the reason you think.

The American Heart Association (AHA) recommends 150 minutes per week of moderate exercise or 75 minutes per week of vigorous exercise. This recommendation is strictly targeted at maintaining your cardiovascular health but has been widely adopted as the right recommendations for weight loss as well. Moderate exercise results in around 200-400 calories burned per hour, depending on your weight and age. Meeting the AHA’s guidelines would result in an additional 500-1000 additional calories burned per week – this can be wiped out in one large meal. Also, moderate exercise will generally increase your appetite by an amount that roughly corresponds to the amount of calories burned, resulting in no net change in your calorie balance. This explains why those with sedentary jobs are no more likely to develop obesity than construction workers. Additionally, the concept that moderate exercise increases your metabolism long after you’ve finished has been proven false by multiple studies. That’s right, spend 45 minutes on the treadmill and you’ll burn around 450 calories – if you finish up your workout routine with a bagel and cream cheese and orange juice, you’ll be no better off from a weight loss perspective as if you slept in and skipped the bagel.

Just because exercise can’t be used to shift your calorie balance toward weight loss does not mean that it shouldn’t be an important part of your lifestyle change.  This video introduces the Pound of Cure approach to exercise and offers a strategy for using exercise in a realistic, safe and appropriate way.

5 thoughts on “Exercise”

    1. Too much math in this article. It does point out that in order to benefit from exercise, you have to do more than most of us think. I focus on higher intensity exercise rather than longer duration, this article does not pay any attention to the intensity of exercise and instead focuses only on duration which I think is a mistake.

  1. I’m eating off the metabolic reset list (I started 2/24/2019). I joined a kickboxing class three times a week, its pretty intense. Since I started exercising, I’m struggling with low blood sugar episodes. I googled if exercising can lower your blood sugar and the answer is yes… People keep telling me I need carbs before I exercise, is this true? And why am I struggling with the low blood sugar, what can I do to fix it?

    1. Yes, you can have low blood sugar when you exercise at a high intensity, particularly if you’ve had weight loss surgery in the past. I agree with the carbohydrate recommendation. This is the exact situation when I like some of the “bad” carbs (not the ugly ones) – steel cut oats and brown rice are probably your best options. I would look into overnight oats that you can eat 30 minutes before you workout, they’re super convenient and delicious.

  2. Thank you, thank you, thank you!!!! I was struggling against the carb thing, because I thought it would undo what I am trying to accomplish. I’ve been eating small meals every couple of hours, trying to mange the sugar level, its been tough. I’m eating way more than I think feels right, but I am still losing. I am loving the kickboxing class, its the first very high intensity workout I’ve ever connected with. I was starting to worry the low sugar thing was going to be an obstacle. I am googling, overnight oats, as we speak… Thank you for being such a great guy Dr. Weiner, you’re the champion for weight challenged people, like myself. Have a wonderful day!!!

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