Recently I posted my reaction to the John Cloud’s Time Magazine story discussing reasons why exercise doesn’t lead to weight loss.
While I critiqued parts of Cloud’s article, I do believe his main point that “exercise won’t make you thin” is a VERY IMPORTANT message for Americans to hear. There are some who can be, and in fact are, successful using exercise to lose weight. But, as a public health professional, I’m more concerned with how to help “the masses” than I am about helping those who are the “exception to the rule”.
Cloud challenges how scientists and fitness professionals have promoted exercise to Americans for many, many years. The actual answers to the questions “did it work?” and “was it sustainable over time?” can be answered by most Americans themselves who have tried to use exercise as a vehicle for weight loss. The answers to these questions have implications for whether exercise should be promoted as a “good” way to lose weight as is typically done, or whether we need to promote other reasons for exercising that busy Americans will find more compelling and motivating.The American College of Sports Medicine (ACSM) responded to the piece, and criticized Cloud for not talking about the differences between the effects of exercise on weight maintenance and the effects of exercise on weight loss. Although I agree that maintaining one’s weight is a very important issue, weight loss and weight maintenance are two very different phenomena, as anyone who has lost and gained their weight back multiple times knows. Because of that, I think there is value in specifically critiquing the role of exercise as it relates to weight loss only.
The ACSM response quoted a leading researcher, for whom I have great respect, who said:
“The statement [by Cloud] ‘in general, for weight loss, exercise is pretty useless’ is not supported by the scientific evidence when there is adherence to a sufficient dose of physical activity in overweight and obese adults (The bolded words are my emphasis.) The underlying assumption in the ACSM critique is that when overweight people exercise sufficiently, evidence suggests that they will lose weight. However, long-term studies, and most importantly, in real life, people don’t adhere to exercise programs for the long term. As a result, most people eventually gain their weight back.
Over the years, exercise physiology research has taught us so many fascinating details about how our body’s biology, physiology, and anatomy change when we maintain a physically active lifestyle. But, and this is very important, we still know very little about how to KEEP people active. I think the most valuable part of Cloud’s controversial article is that it provides a context for us to question the assumptions underlying the typical way medical professionals and our culture promotes exercise to Americans. It opens the door for a much-needed debate about whether promoting exercise as a vehicle for weight loss is the BEST way to motivate Americans to adhere to exercise long-term. Based both on the overwhelming amount of data demonstrating poor long-term adherence in those individuals exercising for weight loss, and on my own research indicating that women with weight-loss goals were among the least motivated to be physically active, I would argue that we need another approach.
There are many incredible wellness and health benefits of exercise, many of which occur completely independent of weight loss. Unfortunately, in our society these benefits often get lost when the focus is on losing weight. My perspective is that instead of debating the science about whether exercise leads effectively to weight loss we should be asking what do we need to do to get people to exercise regularly, and what should we be doing differently that might lead to better success? What are YOUR thoughts about this? In my next post, I’ll respond to your comments about what you think needs to happen to help women maintain a physically active lifestyle. Here are some things I'd love to get your perceptive on:
1. As an American adult, with 20-40 years of experience with your own exercise, weight loss, and/or weight maintenance, what does common sense tell you about how well exercise is, FOR MOST, producing weight loss?
2. What do people need in order to stay motivated to exercise?
3. What do you think experts should do differently to help Americans adhere to exercise?
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For more about what’s sabotaging your motivation for exercising, check out my blog, Women's Essential Steps