When you see this topic, you probably expect me to rattle off the familiar statistics and trends. Something like:
- More than seven out of 10 adults aged 20 years or older in the United States are overweight or obese.1
- Most leading causes of death are tied to unhealthy body composition and the resultant inflammation.
- People fall into yo-yo patterns with cycles of weight loss attempts followed by failed efforts, ending in weight regain or even more added weight.
- Social trends rightfully are working to destigmatize obesity; however, its prevalence and acceptance does not negate the health risks associated with excess adipose tissue.
Let’s flip the script about exercise and weight loss in a couple of ways. You can leverage how you use language around exercise to lower risks and achieve weight loss goals.
Tips for Sustainable Weight Loss
FACT: We can control the inputs (what we do) far more than we can control the output (what happens). Don’t tie exercise goals to a number on a scale. Use language that prioritizes healthy lifestyle choices as the goal instead of a target number of pounds lost or dress size. If someone incrementally increases healthy lifestyle habits, including exercise quality and quantity, the results will most likely follow.
To facilitate successful weight loss, create SMART exercise goals with your patient:
- Specific: Walk 10 minutes at low intensity for three days a week. Move five minutes every hour you are awake.
- Measurable: You can quantify and track these variables: 10 minutes, low intensity (e.g., you could sing and talk while walking), three days, five minutes every hour while awake.
- Achievable: The goals are created as an agreement between clinician and patient.
- Relevant: Walking is a great start for a previously sedentary patient who was properly cleared for exercise despite some limitations and risks.
- Time-bound: Advise the patient to RTC in a few weeks to add in the necessary accountability and partnership it takes to make exercise and movement a lifestyle habit. This can be facilitated by another team member (e.g., health coach) to reduce costs, increase access and leverage skills you might not have.
Despite our best efforts, the truth is things don’t always “work out” as planned. Your patient reports they are eating right and exercising, yet no improvement in body composition is noted. So, what happened? Let’s look at seven ways an exercise routine may inadvertently cause weight gain and how to avoid those pitfalls.
7 Workout Routine Bad Habits (and Solutions!)
1. Watch calories
With all this exercise, patients may unconsciously consume more calories than their body burned while working out. If you’ve ever seen your estimated calorie burn after a run or walk, it isn’t as magnificent as we would all like. People sometimes inflate their perceived calorie burn count and then rationalize extra food with this post-workout confidence. It’s vital we maintain an awareness of calories in and out because it is a fundamental principle of weight loss.
2. Refuel with healthy snacks
The inflation of perceived effort also sometimes leads to rationalizing unhealthy foods and drinks. The 10K run ending at a brewery replete with nuts and pretzels doesn’t make much sense, right? Ask how your patient refuels. Quality of calories is just as important as quantity. I’m a personal fan of functional food shakes. With 30-40 calories per serving of non-dairy milk and some veggies or fruits, these hypoallergenic, anti-inflammatory and nutrient-packed smoothies hit the spot psychologically and physiologically. The predigested proteins are also great post-workout. Half-servings work well to satisfy dessert cravings for many of my patients.
3. Keep it moving
The “exercising couch potato” believes a 30- or 60-minute workout undoes the negative effects of sitting at a desk or on the couch the rest of the day. Studies show sedentary behavior is just as dangerous as cigarette smoking in terms of cardiovascular risks! Consider increasing your NEAT (Non-Exercise Activity Thermogenesis) by taking the stairs, parking far away from the store or getting up to throw away trash at work. We live in a society where it’s too easy to just sit. Consciously use regular movement to keep the body healing.
4. Drink (more) water
Workouts can cause you to lose water and electrolytes through sweat. Unfortunately, many people mistake thirst for hunger and then eat extra calories unnecessarily. Be sure to discuss boosting hydration and electrolytes post-workout so this confusion doesn’t sabotage your patients’ good efforts.
5. Reduce stress
Worrying about hitting a target number on the scale can actually cause weight gain. Cortisol release, inflammation and insulin dysfunction signal the body to store fat. Shift patient goals to sustainable behavior changes instead of a magical weight destination. I’m a fan of counting my yoga and post-workout, 10-minute gratitude meditation as part of my exercise time. Couple exercise with a cool-down walk, and sip on some much-deserved low-calorie hydration with electrolytes (e.g., coconut water). Restorative movement can benefit those with excess stress.
6. Workout earlier
Exercising too late in the day or allowing the workout requirement to cut into a patient’s sleep time is not advisable. If you’re a fan of chronobiology and circadian rhythms, then you know exercise and movement is best done earlier in the day. There’s a natural flow toward slowing down and resting that should begin around sunset, according to many Eastern medical modalities. Sleep optimization is a vital aspect of weight optimization.
7. Incorporate strength training
The old treadmill, walking, jogging, running, cardio-heavy exercise prescription isn’t great for most. Strength training continues to be an important component of sustainably healthy body compositions. While cardio helps lose fat, strength training helps us gain the muscle we need to lose fat and keep it off. Many people, especially women, avoid strength training. Bring the healing power of resistance training into the routine as soon as possible.
Weight Loss is a Journey
Here's the thing: the whole process for weight loss is more about a journey than a destination. There will be peaks and dips, scenic stops and some undesirable weather patterns. The goal is to keep on keeping on. If the above strategies fail to help your patient make forward progress, please do consider evaluating them for undiagnosed diseases, such as thyroid, hormone or mental health issues, that could be at play and must be addressed.
Wishing us all success as we personally and professionally work to optimize our movement and body composition so we can live our best lives!
Shilpa P. Saxena, MD, IFMCP is a board-certified family physician whose passion and purpose come to life through an uncompromising dedication to the ‘health’ and ‘care’ aspects of healthcare. Beyond continuing to practice as Medical Director of Forum Health Tampa, Dr. Saxena serves as Chief Medical Officer at Forum Health. In addition to over 15 years of progressive patient care, Dr. Saxena is Faculty with the Institute for Functional Medicine, as well as contributing faculty or physician educator roles with the Andrew Weil Center for Integrative Medicine, George Washington University’s Metabolic Medicine Institute, University of Miami Miller School of Medicine’s Department of Family Medicine and Community Health, and Universidad San Ignacio de Loyola (Lima, Perú). She joined the Lifestyle Matrix Resource Center team over 10 years ago to help providers, patients and practices around the world deliver effective shared medical appointments through her Group Visit Toolkits. She also continues to serve as the Clinical Expert for the CM Vitals Program.
1. Centers for Disease Control and Prevention. (2022). Obesity and Overweight. National Center for Health Statistics. https://www.cdc.gov/nchs/fastats/obesity-overweight.htm