fitting into skinny genes? the real reasons we struggle with weight loss graeme thomas, msc

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