Myth of the Day: You Must Exercise More to Lose Weight
How many times have you heard the weight loss mantra, “diet and exercise,” or — the new-fangled version — “exercise and diet”?
How many times has your healthcare provider belted out “try diet and exercise” when talking about your cholesterol, blood sugar, or BMI?
How many times have you avoided scheduling your checkup because you’ve been told this mantra every year, yet the number on the scale doesn’t seem to move?
If you answered “a lot” to any of these questions, you’re in excellent company.
This is week #3 of my three-week myth-busting series on diet, exercise, and weight loss.
Today is a deep dive into the myths around weight loss and exercise.
MYTH #3: YOU MUST EXERCISE MORE TO LOSE WEIGHT
Most of my patients who struggle with their weight aren’t unaware of the virtues of consuming kale and the downsides of inactivity. In fact, when it comes to weight loss, they’ve consumed a steady diet of narratives about personal responsibility and willpower (i.e. “eat less, exercise more”). At the same time, they’ve been deprived of more appropriate conversations about weight as the complex intersection of societal, genetic, psychological, behavioral, and nutritional forces.
Some of these forces are out of our control. For example, we cannot change a genetic predisposition to obesity. We cannot insert more hours in the American workday in order to get the sleep, exercise, and nutritious meals many of us aspire to. We cannot instantly alter a medical system that treats obesity as a personal failure rather than an opportunity to understand and work with the whole patient.
But when we’re trying to solve an insidious problem like our own weight loss struggles, we can try to seek agency in places we haven’t looked.
Exercise Won’t Automatically Make You Thinner.
Many of my patients exercise religiously but still have difficulty losing weight. Part of this is normal human physiology. For some of my patients, exercise and not losing weight reflects a common pattern of daytime restrictive eating paired with nighttime compensatory over-eating (as I described last week). And sometimes the extra weight is even due to exercise itself.
To be clear: I’m not saying that increased exercise cannot and will not help some people lose weight in a sustainable, healthy way. It will, and it can. I’m also not saying we shouldn’t take responsibility for our everyday habits in the areas where we actually have choice. We should. Indeed, some of my patients swear by daily exercise for weight loss!
When it comes to exercise, the problem I commonly see isn’t the absence of adequate activity; it’s about why, how, and when we move our bodies. It’s also about how we define health in the first place. So, it’s important to manage our expectations of what exercise may and may not do — and to appreciate the myriad invisible benefits that come from a regular sweat.
Here is my advice if you’re wondering why exercise has not — or currently is not — helping you lose weight:
Manage your expectations.
It makes sense. Brisk walking for 30 minutes burns, on average, around 140 calories, approximately the same number of calories in a 12-ounce latte with 2% milk. Yet, we might assume it’s more. As Gretchen Reynolds writes in the New York Times, “We tend to compensate for some portion of the meager caloric outlay from exercise by eating more afterward or moving less or unconsciously dialing back on our bodies’ metabolic operations to reduce overall daily energy expenditure.”
How we and our bodies “interpret” exercise is partly why there is so much variability between patients in terms of the effectiveness of exercise for weight loss.
Add strength training.
This can be an important piece of the weight loss puzzle. We lose muscle mass as we age. Muscle mass is essential for metabolism and fat-burning — not to mention posture, balance, coordination, flexibility and body image. I’m amazed at how commonly patients report having an easier time losing weight — thereby improving their cholesterol, blood sugar, waist circumference, and metabolic profile — when they add, give or take, 20 minutes of resistance training three times a week. Some simple ways to get strength training are though:
Yoga. (If unable to “downward” your dog, try chair yoga!)
Pilates, on the mat or with a Reformer.
Lifting light weights.
Working with a trainer, either online or in person.
Formal physical therapy. I think every patient should have a good body mechanic in their speed-dial — for tune-ups when needed and for maintenance of good skeletal health. Ask your insurance if they’d cover it.
Consider exercising in the morning.
If exercise was working and now it isn’t, consider switching up your routine. Some studies suggest that exercising in the morning is better for weight loss when compared to exercising in the afternoon or evening hours, all other variables being the same. Starting the day with a fresh hit of dopamine and relaxed muscles can improve mood, focus, and, for many people, the ability to make healthier food choices during the day.
The change doesn’t have to be all or nothing: You can start by trying to be a morning exerciser twice or three times a week for two or three weeks and see how it goes.
Ask yourself if you actually need to lose weight — and consider tossing out your scale.
Perhaps like my newsletter reader from two weeks ago whose BMI is technically “too high” but whose exercise routine and metabolic markers are terrific, it might be time to reassess what it means to be healthy.
It’s true: muscle weighs more than fat. It is therefore not uncommon for people to gain weight when they exercise more. This is okay.
Moreover, exercise has myriad benefits aside from its potential to help people lose weight. A fascinating review from September 2021 proposes a “weight-neutral” approach to patients with obesity and overweight, arguing that exercise is more important than weight loss in terms of overall health and longevity. Here is the key figure from the abstract:
Regardless of baseline weight, regular physical activity has been shown again and again to help everything from mood stability, attention and focus, to preventing dementia, diabetes and heart disease. Arguably the ONLY medical issue that exercise doesn’t help with is compulsive exercise (see below).
Ask yourself if you’re exercising too much.
If you just spit out your drink laughing as you read this, you can skip to the next section. But believe it or not, many of my patients have so deeply internalized the importance of exercise that their routine is inadvertently adding both physical and emotional weight.
Modern society celebrates exercise and fitness. Sneakers are in vogue — not just at the gym but on red carpets and runways. The mental health benefits of exercise have finally gone mainstream, too. Psychiatrists prescribe Prozac and push-ups. Therapists suggest movement alongside mindfulness techniques. TJ Maxx even sells mugs that read, “Exercise is cheaper than therapy.”
All of this is generally good, but just because exercise is good for us doesn’t always mean that more is better.
I commonly see this cycle with patients: over-relying on exercise to manage stress and/or to lose or maintain weight, then upping the exercise when their stress or weight slightly increases — at the very moment their body probably needs rest. As a result of overriding their physical and emotional needs, the added exercise actually exacerbates exhaustion and stress. It also frequently adds weight, guilt, and even more stress. Why is this the case? When stress is high, cortisol levels spike. When cortisol increases, we’re more likely to snack on high-calorie foods, feel anxious or sleepless, and/or to gain weight from being in perpetual “survival mode.”
Exercise is problematic when it exhausts us instead of refreshing us — or when it adds to our stress instead of reducing it.
It’s important to ask ourselves first: What do I really need right now to feel calm or more in control of my body? Sometimes, it’s not going for a hard ride on the Peloton; it may be an extra hour of sleep or a dose of self-compassion.
The upshot? It may be time to reassess your relationship with exercise. The goal is for you to control when, how much, and why you exercise — and not for exercise to have control over you.
The bottom line
It’s time to decouple weight from worthiness — and from the overwhelming reason to get moving.
Weight is just a number. Exercise is good for nearly every aspect of our physical and mental health. It’s time to find joy and pleasure in physical activities and to think bigger and better than simply “I must exercise for weight loss.” It’s time to understand obesity and overweight not as a personal failure but as an opportunity for self-exploration, awareness, and compassion.
Health is a process, not an outcome. It stems from having wisdom about — and some agency over — the myriad, dynamic factors that govern our bodies and mind.
The most difficult part? Accepting the things we cannot control. Unfortunately that’s the hardest pill to swallow.
This week on the pod! Gwyneth Paltrow’s former right-hand woman at goop and current “It Girl” for Grown-Ups, Elise Leohnen, joins me to discuss the definition of wellness — and the tendency for women to manipulate their bodies for the sake of “well-being.”
Elise understands health as the complex intersection of mental, physical and spiritual health. She has created a cult following through her own writing, Instagram monologues, and her hit podcast Pulling the Thread. Each week, she brings her fans on a journey of self-discovery, pondering life’s biggest questions alongside cultural luminaries like Gabor Mate, Susan Cain, and Nedra Tawwad, sprinkled with her signature warmth and curiosity.
On this episode of Beyond the Prescription, Elise shares with me her own encounters with Western medicine, her complicated wellness journey, and how she envisions leading a healthy and fulfilling life. Elise opens up about the physical manifestations of emotional stress, the power of introspection, and her multi-factorial intuitive understanding of healing.
As always, my newsletter subscribers get early access to the pod every Monday night before the official Tuesday launch. Give it a listen now on Apple, Spotify, or wherever you find podcasts. And I’d be thrilled if you could rate and review the show. It helps me a ton!
I will see you next week. Until then, be well.