fitting into skinny genes? the real reasons we struggle with weight loss graeme thomas, msc
TRANSCRIPT
Fitting into Skinny Genes?The Real Reasons We Struggle with
Weight Loss
Graeme Thomas, MSc.
Weight Loss 101
“Energy can neither be created nor destroyed. It can only change forms.”
Calories In = Calories Out
We “Know” More About Dieting Than Ever
Obesity Trends* Among U.S. AdultsBRFSS, 1985
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% BMI: Body Mass Index, 20-25 is ideal
Obesity Trends* Among U.S. AdultsBRFSS, 1986
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1987
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1988
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1989
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1990
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14%
Obesity Trends* Among U.S. AdultsBRFSS, 1991
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1992
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1993
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1994
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1995
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1996
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19%
Obesity Trends* Among U.S. AdultsBRFSS, 1997
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24%
Obesity Trends* Among U.S. AdultsBRFSS, 1998
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24%
Obesity Trends* Among U.S. AdultsBRFSS, 1999
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24%
Obesity Trends* Among U.S. AdultsBRFSS, 2000
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24%
Obesity Trends* Among U.S. AdultsBRFSS, 2001
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. Adults BRFSS, 2002
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%
Obesity Trends* Among U.S. AdultsBRFSS, 2003
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2004
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29%
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 2005
(*BMI ≥30, or ~ 30 lbs. overweight for 5’ 4” person)
Obesity Trends* Among U.S. AdultsBRFSS, 2006
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
1998
(*BMI 30, or about 30 lbs. overweight for 5’4” person)
2006
1990
No Data <10% 10%–14% 15%–19% 20%–24% 25%–29% ≥30%
Obesity Trends* Among U.S. AdultsBRFSS, 1990, 1998, 2006
Oh Canada?
In under 30 years, obesity
rates have doubled!
The Shocking Reality
Is Weight Loss Rocket Science?
Things Weight Loss Experts Historically Have Told Their Clients…
• Calories In = Calories Out
• Burn More Calories Through Exercise To Lose More Weight
• “Everything in Moderation...” and you need to eat “a balanced diet...”
Weight Loss 101
“Energy can neither be created nor destroyed. It can only change forms.”
Calories In = Calories Out
Energy Balance
1 lbs of fat = 3500 kcal
Expenditure Basal metabolism Activity Digestion
Input FAT 9 kcal/g CHO 4 kcal/g PRO 4 kcal/g Alcohol 7 kcal/g
Clearly We Have a Balance Problem!
Weight Loss Prescription1. 1 lbs of fat = 3500 kcal
2. A deficit of 500 kcal/day 1 lbs fat loss per week
• Yet our failure rates with diets are well over 90%!
Health Experts Suck at Math!
If we accept an excess of:• 3,500 kcal 1 lbs of fat
Then to gain 5 lbs in a year:• 5 x 3500 kcal 17,500 kcal
Which means our balance is “off”:• 17,500 kcal / 365 day 47.8 kcal/day!
Dietary Intake PatternsFrom 1991-2001: Increased our consumption by over 400 kcal/day!
+400 kcal/day predicts a weight gain of ~42 lbs a year!!
How to Become a Millionaire…
Making Weight Loss a Math Equation
Currently, > 90% who lose weight on a diet will regain it all back!
So Where Have We Gone wrong?
aka What Do We Think We Know…
The Question We Are Going To Answer
Is Exercise or Diet More Important For Getting Lean?
The Obvious Answer…
Yes
Exercise: Confusion, Lies and just plain bad science
The Exercise Challenge
• Regular Exercise for 16 months• Young men and women (avg age: ~22 and ~24)• 20 – 45 minutes a session, 5x/week
Goal: 400 kcal per session or 2000 kcal per week
• Exercise Intensity• Males: 154 ± 11 bpm; 77% max HR• Women: 156 ± 9 bpm, 80% max HR
Donnelly et al. (2003) Arch Intern Med. 163:1343-1350
Exercise and Body Weight
Males Exer-cise
Males Con-trol
Females Ex-ercise
Females Con-trol
Weight Baseline
94 94.1 77 79.9
Weight 16 Months
88.8 93.6 77.6 82.8
72.5
77.5
82.5
87.5
92.5
97.5
Effect of 16 Month Exercise Intervention
Body
wei
ght (
kg)
*
*
Exercise and Body Fat
Males Exer-cise
Males Con-trol
Females Ex-ercise
Females Con-trol
Body Fat Baseline
26.8 25.5 27.4 29.4
Body Fat 16 Months
21.9 24.8 27.2 31.6
2.57.5
12.517.522.527.532.5
Effect of 16 Month Exercise Intervention
Body
Fat
(kg)
*
The Very Important Conclusion
Men are Losers!
But Seriously, Guys are Losers
Men: lost 5.2 kgWomen: remained weight stable
Size differences?
• During exercise• Men average 6.7 ± 0.8 kcal/kg • Women average 5.4 ± 1.1 kcal/kg
• Men burn ~20% more energy doing exercise of the same intensity!
Key Concept
Females should not base their fat loss efforts around steady state exercise!
Your Metabolism Is Smarter Than You Are
Sullivan EL & Cameron JL. (2010). Am J Physiol Regul Integr Comp Physiol
How Do You Compensate?
King et al. (2008) International Journal of Obesity, 32, 177–184
12 weeks5 exercise sessions per week500 kcal expended per session
Average weight loss
Exercise a ton, gain more weight!
Steady State Exercise Summary
Key Fat Loss Concept:
For most females, simply exercising more or dramatically cutting calories rarely works.
More is not better, better is better.
Hold The Phone Guys…
Fat Loss is a Hormone Problem
• Body fat is designed to regulate itself!!• Humans are not optimized for weight loss
• Obesity no longer just a disorder of simple caloric excess• Fat incredibly metabolically active
• Leptin, estrogen
Weight Loss Revelation
Energy Has to Balance Here…
Calories Matter… But You Can’t Measure Them!
So If Exercise Doesn’t Work, It Must Be All Diet…
12 Week Makeover?
• Weight Watchers vs. Gold’s Gym Quick StartBall & Bolhofner (2008). Journal of Exercise Physiology, 11, 1-9.
• 43 subjects• Initial body fat ~40%• WW: given diet/exercise advise, weekly weigh-ins• GG: 3x weight training + additional cardio
• Unsupervised
Body Weight
Gold's GymWeight Watchers
72747678808284
76.9
82.7
75.6
78.6Pre-Post-
*
(kg)
% Body Fat
Gold's GymWeight Watchers
353637383940414243
37.6
42.4
38.4
41.3
Pre-Post-
In other words
• Exercise alone• Not much weight or body fat change• Often increases hunger
• Calorie restriction-only plans• You might lose weight• But remain a smaller version of your previous self
So How Does Exercise Actually Help With Weight Loss?
But how exactly do we accomplish this?
Mission Thin-Possible
• 12 Week Weight Loss Context• Starts Sept 19th
• 1 Grand Prize Winner wins $10,000• Expert training guidance + nutrition seminars• Massive boost to accountability
Resistance Training During a Diet
• Over this 10 week study, older (mean age of 67 years), overweight individuals were placed into one of two conditions.
• Diet alone (DASH): a 10% reduction in total calories
• Diet + exercise (DASH+RT): same reduction in calories + 3 full body resistance training sessions
1. Avila et al. (2010), Effect of moderate intensity resistance training during weight loss on body composition and physical performance in overweight older adults, European Journal of Applied Physiology, February 2010
Key Concept:
During a period of calorie restriction, it is imperative to resistance train, in order to preserve lean mass.
Training Long vs. Training Hard
• Endurance training• 3x week• 2 weeks each 30-45-60
minutes @ 65% VO2max• Total exercise time:
• 13 ½ hours
• Sprint training• 3x week• 4-6 30-second max effort
sprints• 4 minutes of recovery• Total exercise time:
• 6 ¾ hours (6 hours rest, 45 minutes work)
Fat Mass (kg)
Sprint Endurance10.0
10.5
11.0
11.5
12.0
12.5
13.0
13.5
14.0
14.5
13.7 13.87
12.03
13.05
kg
= Pre= Post
* *
Intensity is Key
• Endurance– Decrease 1.1% body fat– Lost 0.7 kg of fat mass
• Sprint– Decrease 1.8% body fat– Lost 1.7 kg of fat mass
• Exercise CANNOT undo a bad diet• 30 minutes of exercise to burn 300 calories• 30 seconds of donut eating to replace those calories...
Key Exercise for Fat Loss Take Away
• The important question is not many calories you burn during a workout… instead ask yourself:
What kind of 24-48 hour impact is your training having?
• Calorie restriction will drive fat loss, exercise is vital to protect lean mass and influence fat loss hormones• Lean mass protection is one of the strongest predictors of
long-term weight loss maintenance• If you aren’t already weight training, start now
What The Experts Missed…
IntakeIntake ExpenditureExpenditure
Resting Metabolism50-70%
Resting Metabolism50-70%
Digestion5-10%
Digestion5-10%
Physical Activity10-30%
Physical Activity10-30%
FoodFoodHarder to influence, but payoff is worth it!
SubstantialControl
Total control
Some control
For Next Time…
• Calories In = Calories Out
• Burn More Calories Through Exercise To Lose More Weight
Mission Thin Seminar Series
• Program starts Sept 19th• “Everything in Moderation...” and you need to eat “a balanced
diet...”
Secrets to Weight Loss Success
1. I Know2. I Do3. I Am
Your Bonus
1. If you’d like a copy of these slides• The “I know”
2. Diet Overhaul Handouts• The “I do”
• Make sure you add your name and email address to the sign-up form being circulated• Please print legibly!
What Are You Going to Do?
“If I am not for myself, who will be for me?If I am not for others, what am I?
And if not now, when?”
- Rabbi Hillel