More Random Thoughts: Obesity, Weight loss, Exercise & Moving like a Thin Person

I get the feeling from the comments on my last Random Thoughts post and the NEAT post that folks think I'm pretty down on HIT resistance training or HIIT "cardio".  Not true.  But it would be fair to say I am pretty down on the "culture" surrounding these minimalist-time protocols.  I know, I know, telling people that they'll have to walk for an hour a day every day to stave off weight gain is so old school conventional wisdom and downright unsexy.  OTOH, it's highly appealing to us to get all the benefits of any thing doing it slightly differently in less time!  So it's not the merits of the methods themselves that I have an issue with, it's the whole "be super fit and buff in 10 minutes a week!" ... implied:  and you can sit on your butt the rest of the time.  There's a distinct tone of discouraging good old fashioned "cardio" that frequently skirts close to putting down those who engage in it as stupid drones and needlessly stressing folks concerning overtraining.  So complete with calorie denial for how what you're eating impacts weight, you're also required to deny that a sedentary lifestyle has anything to do with it, complete with promises that you really only need like 6 seconds a day of exercise to accomplish the body of Mark Sisson.  It's the ONLY that is something the obese want to hear but will likely fail them in the end.  As I've said before, it's possible to reduce one's obesity and maintain it with a sedentary lifestyle, but the deck is stacked massively against you.

One can't help but write a post like this without mentioning the physiques of many of those putting forth the theories.  Is there a single post-obese person out there with a blog or website or FB page or whatever who just maintains a lean mean fighting machine physique through diet and less than 15 minutes deliberate exercise per week?  With all the talk of slow lifting to failure, I couldn't help being reminded of Fred Hahn, and with being reminded of Hahn comes flashbacks from the abomination that was The 6 Week Cure for the Middle Aged Middle by the Drs. Eades.  I mean think about this folks.  These two co-authored a book with Fred Hahn in 2003 called The Slow Burn Fitness Revolution.  On page 76 of my Sony e-book version of 6WC the Eades' write:

To achieve this end quickly, without spending hours and hours in the gym, we recommend the slow-speed, strength-training method.  As mentioned previously, we co-authored a book on the subject with New York fitness guru Fred Hahn.   If you're interested in gaining muscle mass and strengthening your middle-aged bones, and doing it in as little as 30 minutes a week, find a slow-speed strength trainer in your area or follow the guidelines in The Slow Burn Fitness Revolution.

By learning to eat right and exercise differently, you can make giant strides toward whittling down your middle in a short space of time, strides that years of ELEM [Eating Less Exercising More] could never achieve.  And best of all, you'll have mastered the tools that will let you keep your middle trim from now on.

The above excerpt immediately followed that famous shirtless shot of Mark Sisson and a discussion on how you don't need to do "ab work" for that six-pack, just do Laplace isometrics -- basically holding in your tummy -- because Mark got his abs from doing just that.  Yeah, Mark got his physique with no head start from decades as an endurance athlete producing very low body fat.  Right ...  And I'm tired of this notion that these exercises are any less ab work than doing crunches or somesuch.  You're working your abs!  But I'm sure the irony of all of this does not escape my regular readers.   Just exactly how lazy are the Eades' if they know the "secret" that requires less than a half hour out of a week, and helped "write the book", but can't be bothered to do even that much??  I get their pitch for resistance training in the book, I don't get their utter hypocrisy in either not practicing what they preach or encouraging such a minimalist approach and providing "tools" that don't work for them!  After all, they were the guinea pigs for their diet, and again in 2012, we have them resolving to diet ...   But ... oh ... it's because of their damaged metabolisms that they can't pig out on vacation and not suffer the consequences.

Let me be very clear here.  I'm absolutely not knocking those who employ these training techniques so long as they're working for you.  And I feel the appeal of spending less time deliberately exercising especially if your schedule is very busy.   But to me, fostering this notion that someone will be transformed from a couch potato bod to anything resembling a Mark Sisson or even a Fred Hahn by doing "just" that much exercise is not helpful to the vast majority of the obese.  

I totally get how sedentary behavior sets in even with obesity, even for formerly active folks who become significantly overweight later.  As I've shared previously, my own sedentary behavior came about from a combination of being less social = less time outside the home doing just normal activities and not wanting to engage in too much activity based on knowing it would lead to physical awkwardness, discomfort and/or outright pain.  Still, I was somewhat surprised by the differences in activity between the lean and mildly obese in the NEAT study.      Granted the sample sizes were small, but the differences were considerable for the sitting vs. standing/walking.  Almost 3 hours a day ... and this compared self-described couch potato lean and mildly obese, I can only imagine the difference between the recreationally active lean and more morbidly obese.   The lean were not as couch potatoey after all, though sedentary, yes.

So there are two things here.  First, the obese are already at a NEAT deficit compared to lean with self-described sedentary behavior.  While it is possible their NEAT will go up spontaneously as they lose weight -- my own no doubt did -- it's not a given that it will increase enough to compensate for reduction in RMR.  Old habits die hard, and many people can manage consciously eating less for a long time, but if you're used to eating 3000 cal/day, eating 1500 cal/day from here on out may well not be sustainable for you.  Leaving chillin' out of this, the only other option is to increase increase AT be it NEAT or EAT.  In this regard, the short exercise bouts lack something essential:  time.  Walking slowly for an hour vs. 15 minutes of fast walking involves standing for 45 more minutes.  You may get other benefits -- including calorie burn -- walking very fast for those 15 minutes -- but the "NEAT" part of your exercise is less, if the next thing you're doing is plopping back down in a chair feeling all proud of yourself for having exercised that day.   While being stronger can help with everyday activities, resistance training doesn't acclimate your joints and muscles for extended periods of movement or just being on your feet.  Don't tell the paleo peeps, but I like to wear heels to work.   I mostly go barefoot or wear flat shoes in the summer when I generally don't teach.  Every September it takes me several weeks to adapt again to walking on heels.  I'm more likely to be found standing other times in the day when my feet aren't killing me!  Makes sense I hope?  

Further more, a bit of my ranting is aimed at not only the promotion of "the least amount of time (read: effort) possible", but also the discouraging of moving more in general.  In many cases I presume this is not the intention, but it seems to be interpreted that way more often than not by consumers of the advice -- many of whom have been indoctrinated into some new low carb dogma that exercise is useless.   There's no excuse for the Eades and Taubes in this regard, but many others are far more innocent.  Take Chris Kresser for example.  Chris is a fairly young, tall, lean guy who doesn't look like he's spent a day in his life fighting weight gain let alone obesity.   I don't think Chris realizes how some interpret articles such as Why you may need to exercise less, having never been in the situation many reading such are coming from.   Many in the audience are indeed waging a battle with excess weight and running up against dead ends short of goal.  Such posts providing a litany of reasons for why too much "moving" is the cause of their problems ring defeatist in a way -- it's the best you can do, cut back and let things work themselves magically out now, and if that doesn't do it ...    This seems especially true of the LC'ers who have hit that plateau or are regaining despite "doing everything right", and when they stop the exercise and gain weight?  Well, that's the best you can hope for with your damaged metabolism.   

There can be no doubt cortisol can influence fuel partitioning, it particularly seems to influence fat distribution to visceral depots, but it is no more a magical-matter-maker than insulin.  Thus levels may well impact activity levels, metabolic rate, water retention, etc., and it may cause an increasing waistline as weight remains relatively constant, but cortisol cannot out-maneuver a caloric deficit for very long.  So,  those on a long stall will read this type of post and think, I'm working out too much.  Or if they're not working out already, it's more like "what's the point?" and they never explore their options.  Look, I have no doubt that some do overtrain, but the point I have been trying to get across is that for the obese, many have got a few hours per day to make up to increase activity levels to that of lean sedentary people.   In other words, walking for an hour is not "exercise" but just upping the activity level to "move like a thin person".   Lest this depress too many reading this, I doubt it's quite that bleak as most will increase NEAT spontaneously once significant weight is shed from their bodies.

Still not hearing me?  Here's Chris again, this time in a post on interval training entitled How to lose weight and prevent diabetes in 6 minutes a week.  I'll get to some of that content in a minute, but considering the title, one might assume that 6 minutes a week of exercise is all that Chris does.  He writes:

Aside from the Body By Science (BBS) weight workout which I perform once a week, I stay active on a daily basis. I ride my bike or walk to work or to do errands, and rarely drive my car. I go on walks in the woods or on the beach. I surf when time permits. But I don’t do anything else for “exercise”. This routine not only feels great, it fits very well with my lifestyle and it is completely sustainable. It doesn’t feel like an effort at all.

Anything else???  I don't know how far work is from his home and/or those locations he runs errands to, but in many worlds this is the stuff called "exercise".  There are myriad reasons why someone might drive to work (time, safety, long commute) or not go on walks in the woods or on the beach, but rather hop on a treadmill in their basement.  The latter is considered exercise but, as Chris channeled Stephan, for him, it's just "life" or being active.

This [HIT resistance training] is, in fact, the method of training I’ve been doing since April [~8 months] of this year. I admit I was somewhat skeptical about it all before I read Body By Science. But the research and the physiology was convincing, so I decided to give it a try.

The results have been incredible. My workout varies in length between 5 and 9 minutes a week. That’s right, I said minutes. With only a few exceptions, I’ve increased the amount of weight I can lift, the time I can lift it, or both, with each successive workout. My strength has increased and my physique is, if anything, better than it was when I was lifting 3x/week for much longer periods.

It goes without saying that it takes far less time/effort to maintain one's lean body mass, physique and fitness level than it does to build it. I've not seen any before/after pics of all this muscle building going on with the Jimster, nor Dana's husband for that matter (Dana seems to have jumped the Total Gym Transformation ship). Even Chris -- beginning from a resistance trained lean and active state -- while calling it "incredible"  doesn't claim to have transformed his body much if any.  I would expect some improvements after 8 months ... better or worse than continuing 8 months doing the former routine?  Nobody can tell ... and that's OK.  So, can it work? Sure.  (But so can cardio which is why Chris' subtitle to the contrary doesn't sit with me).   And depending on your goals, it might well be the way to go.  Something is almost always better than nothing! The points that have been made in comments about the time cost v. benefit ratio are well taken -- unless I'm competing or pursuing optimal physique out of vanity (nothing wrong with that unless you can't pass a mirror without stopping to puff up and admire yourself), double the time for little additional practical results seems silly.  Or again ... does it?  What if there are benefits past a few lab measurements.

I'm not overly convinced by the journal articles Chris cites, especially the 6 minute one that showed some trunk fat losses in inactive normal young women after 15 weeks of HIIT compared with cardio and no exercise.  (I have the full text and may look at this more closely at some point ... dropouts could render the results moot depending on whether this was analyzed for completers or with "intent-to-treat").  Most of the studies supporting HIT or HIIT start with either "recreationally active" people or "trained".  So, I've struggled to reconcile how this applied to the obese and what I'm trying to say here.  Then it hit me, one of those "J" sorts of curves popped into my head.  Excuse my crude rendering here of an inverted shallow J-curve.

Now, the "couch potatoes" in my NEAT study think they're somewhere between A & B.  It turns out the mildly obese ones were closer to A while the lean ones may well be closer to B.  You'll note I tried to flatten out the top of my inverted "J" as a wide range of activity levels does not seem to repeatedly produce much in the way of improvements past some point.  On this curve, just adding 6 minutes a day of intervals is perhaps going to have some impact on health/fitness as the slope of this part is steep.  Take someone at A and add several hours slow-to-moderate cardio and they're getting to B or even C and seeing improvements.  Take someone already at C (like, perhaps Chris) and adding in the same amount of cardio on top of what he already does in "life" and he becomes "trained" seeing modest improvements.  Take someone who trains regularly at point D and have them train more?  Then you're talking going into overtraining territory where it may well offer no benefit or even harm.  These are the folks I believe Chris' maybe-exercise-less article is directed towards.  The post on just 6 minutes a day will benefit those who are already normally active which is what Chris describes.  Many might consider that highly active, but it's not really, it's normal, and may be more optimal for those more active who want to improve performance, etc.   While I'm sure it helps someone in the A-B range -- likely on some different curve -- it will not help the sedentary obese person "train" to move like a thin person.

So, I'd like to see more encouraging of movement in general for those seeking to reverse obesity and maintain their leaner selves.  Exercise for weight loss and maintenance from a +20 or even +30 lb from ideal state is far different than exercise for weight loss and maintenance from the 100+ lb overweight let alone someone who starts out 200 or even 300 lbs overweight.  In this regard, the so-called "old" or supposedly "flawed" paradigm works just fine.  The trick, or secret, if there even is one, is to find a way to make it doable and sustainable.    Because even the most amazingly effective 6 minutes of exercise a week is crap if you don't do it.   I loved how Chris signed off on his blog post:

Final note to slackers: the popular excuse of “I don’t have time to exercise” is no longer valid. You’ve got 6 minutes a week to do this. I know you do.

Paging Doctor Mike!

Now can I  hear a *Move More* when appropriate?