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"Waist Management" - Exercise and Weight Loss

Posted on: Thursday, 9 June 2005, 06:00 CDT

As a bariatrician (a physician who specializes in the medical treatment of the overweight and obese), I am constantly amazed at the amount of misinformation disseminated to the public by nutritionists, personal trainers, the media and healthcare professionals, too, in reference to effective treatment for weight loss and, more importantly, long term weight control.

Obesity..The Epidemic

We all agree that being overweight or obese has reached epidemic proportions, with 60% of adult Americans now considered to be overweight. We all agree that because of this "epidemic," the incidence of obesity related dis eases such as diabetes and hypertension are also increasing. Surely the consumption of fast food, processed food and refined sugar combined with too little exercise has added insult to injury.

However, six years ago the National Institutes of Health created new guidelines for what they considered a "healthy" weight. As a result of these guidelines, which were based on a review of 29,000 scientific papers, 35,000,000 Americans were classified as overweight-overnight! So, though the obesity epidemic is real, almost 1/3 of it occurred in one day.

Obesity..The Disease

Obesity is a disease and is considered such by the American Medical Association, the American Society of Bariatric Physicians, the North American Association for the Study of Obesity and-since 2002-even the Internal Revenue Service. Obesity is indeed a metabolic, chronic and progressive disease with a significant genetic predisposition. In fact, it's very much like its co-morbid cousins diabetes and hypertension with two notable differences: obesity cannot be hidden from those around you or the mirror in front of you; and it is 100% diagnosable.

The traditional paradigm for weight loss, i.e., diet, exercise and behavior modification, has proven ineffective for the vast majority of people. As a result, there has been a need for a more aggressive medical approach using combination pharmacotherapy in addition to the above-mentioned protocols to achieve long term weight loss and maintenance. This article will discuss why exercise, although an important adjunct to weight loss, needs to be placed in proper perspective.

Good news and bad news

The good news is that exercise is a very important part of any prudent long term weight loss program - commercial or medical. The bad news is that the ability of exercise to cause weight loss is highly overrated. To be sure, there are many benefits associated with exercise including improved cardiovascular fitness, toning, strengthening, elevating good cholesterol, etc. However, in a weight loss program the purpose of exercise is not for weight loss itself, but rather for weight loss maintenance. The reason for this is quite simple.

How many calories does one burn from exercise and the transient increase in metabolism which follows? Unfortunately, for most of us the answer is "not too many." How many of you go to the gym five days per week, have a personal trainer, walk at lunch, take the stairs, etc., and yet are totally frustrated by the lack of weight loss and in some cases weight gain?

The statistics for weight loss resulting from exercise are the same at Weight No More as they are at UCLA, Mayo Clinic and Cedars Sinai. For example, if you weight 180 lbs., want to lose 1 lb. of fat through exercise, and live in Newport Beach, instead of parking your car farther away in the parking lot, you would need to park at the junction of the 15 and 91 freeways, walk at 4 miles/hour (quick pace) for 8 hours and cover 32 miles.

Alternatively, you could swim 7-1/2 miles at 25 yards/minute to lose that same 1 Ib. When Oprah was at her leanest, she was jogging 95 miles/week! Of course the more you weigh, the less exercise you need to lose a pound, but you have more pounds to lose, and vice versa. At my weight (150 lbs.), I need to run at 10 miles/hour for 3- 1/2 hours and cover 35 miles for a 1-lb. loss.

Admittedly, the National Weight Registry has in its database 5,000 people who have lost 30 pounds through exercise and kept it off for a year. I congratulate them on their success. In that there are 130 million overweight people in our country, this 5,000 represents .0038% (thirty-eight ten-thousands of one percent)!

Although exercise is a most important adjunct in a weight loss program, my hope is that physicians and patients alike will put it in proper perspective. This disease - obesity - needs to be taken seriously, treated seriously and treated with respect.

WEIGHT LOSS BELIEVE IT OR NOT!

* Researchers estimate there are approximately 1,000 genes related to weight control (over 200 have been identified.

* Vitamin injections are worthless for weight loss.

* Slim-Fast, touted for weight loss, has 12 more grams of sugar and more saturated fat than Boost, touted for weight gain.

* Average weight loss at Weight Watchers after two years is 6 pounds.

* There are no published medical studies that show long term weight loss (3-4 years) of even 10% of body weight based on diet and exercise alone.

* All of the above including this statement are true.

How many of you go to the gym five days per week, have a personal trainer, walk at lunch, take the stairs, etc., and yet are totally frustrated by the lack of weight loss and in some cases weight gain?

Dr. Skversky

by Robert Skversky, M.D.

Dr. Skversky is the medical director of Weight No More. He has committed the past twelve years of his professional career to the medical treatment of the overweight and obese patient. He is a member of the American Society of Bariatric Physicians, AMA and OCMA. Dr. Skversky can be reached at (949) 645-2930.

Copyright CBJ, L. P. May 16-May 22, 2005

Source: Orange County Business Journal

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