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Exercise Challenges Weight Loss as Healthiest

Published: 2021-12-20
Exercise Challenges Weight Loss as Healthiest
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Fat and fun are three-letter words not often uttered in the same breath. 

But in the case of this report fat—as in obesity—and fun—as in sports—are the subject of a  study implying in obesity treatment that playing sports is better for you than losing weight.

Those are paraphrased conclusions of an iScience review and assessment by Arizona State University Professor Glen Gaesser and Dr. Angadi Siddhartha of the University of Virginia.

While the study is not a passport to perpetual paunch, it does squarely punch the billion-dollar weight loss industry in a vital part.

Formally entitled Obesity Treatment:  Weight Loss Versus Increasing Fitness and Physical Activity for Reducing Health Risk, the full study is available here.  

The paper, saying that physical exercise is a healthier way to treat obesity than up and down weight loss cycling is a bullseye to the life and play styles SportsEdTV supports, encourages, and promotes.

Our admitted weighted enthusiasms are balanced by Gretchen Reynolds’ New York Times introductory words: 

The review adds to mounting evidence that most of us can be healthy at any weight if we are also active enough.

 To be clear Professor Gaesser’s prescriptions are not specific to sports.  Rather the report uses terms like physical activity and cardiorespiratory fitness to label the healthier road to treating obesity. 

The next time your favorite athlete is on the sideline, hands-on-hips, dripping wet and sucking in air, ask if their cardiorespiratory fitness is up to par. 

Drs.  Gaesser and Siddhartha propose a weight neutral strategy for obesity treatment based on these grounds:

  • The mortality risk associated with obesity is largely attenuated or eliminated by moderate to high levels of cardiorespiratory fitness (CRF) or physical activity (PA)
  • Most cardiometabolic risk markers associated with obesity can be improved with exercise independent of weight loss and by a magnitude similar to that observed with weight loss programs.
  • Weight loss even if intentional is not consistently associated with lower mortality risk.
  • Increases in cardiorespiratory fitness or physical activity are consistently associated with greater reductions in mortality risk than is intentional weight loss.
  • Weight cycling is associated with numerous adverse health outcomes including increased mortality.

As the researchers conclude, their approach is not in rigid opposition to weight loss in the treatment of obesity, saying "such an approach does not assume that obesity is entirely benign or that there are not circumstances that necessitate weight loss."

Digesting the paper’s conclusions:

The increased prevalence of weight loss attempts in the United States has coincided with the increased prevalence of obesity. Thus, a weight-centric approach to obesity treatment and prevention has been largely ineffective.

It is unlikely that continued focus on weight loss as the primary metric for success will reverse the trends in obesity prevalence or result in sustainable weight loss. Chronic weight cycling is the norm for millions of adults and is likely to remain so for as long as weight loss persists as the cornerstone of obesity treatment. Weight cycling is associated with health risks that are very similar to those associated with obesity, including higher all-cause mortality risk, and may contribute to weight gain.

A weight-neutral approach to treating obesity-related health conditions may be as, or more, effective than a weight-loss-centered approach, and could avoid pitfalls associated with repeated weight loss failure.

 However, many obesity-related health conditions are more likely attributable to low PA and CRF rather than obesity per se. Epidemiological studies show that CRF and PA significantly attenuate, and sometimes eliminate, the increased mortality risk associated with obesity.

More importantly, increasing PA or CRF is consistently associated with a greater reduction in risk of all-cause and CVD mortality than intentional weight loss. In addition, improvements in major cardiometabolic risk markers with exercise training are comparable to those associated with weight loss typically achieved by caloric restriction.

We acknowledge that focusing on PA and CRF without establishing a specific weight-loss target is a challenging proposition when nearly three-fourths of women and more than half of men desire to weigh less.  However, desire is often incompatible with physiology, and this is evident with weight loss.

The amount of weight individuals with obesity frequently indicate that they would like to lose is greater than what is recommended and considerably greater than the typically observed values with weight-loss interventions.  Alternatively, these individuals may be more willing to adopt a weight-neutral PA program if health care professionals promoted this perspective more vigorously and regularly emphasized the health benefits of increasing PA and reducing sedentary behaviors in the absence of weight loss.

Increasing PA and CRF should be a high priority throughout the health care system. In addition to the obvious health benefits, increasing CRF may also substantially reduce health care costs.

The 70 plus billion dollar weight loss industry might not have as strong a position as those taken by Drs. Gaessler and Siddhartha in their paper which references 200 other relatable studies and analyses.

SportsEdTV asked Dr. Wickham Simonds about the proposition that exercise is healthier than weight loss when it comes to treating obesity. 

While Dr. Simonds did not have the opportunity to review the Gaessler-Siddhartha paper, when we asked, his long tenure as a trustee of the Obesity Medicine Association has exposed him to the myriad iterations, innovations, and exaggerations of the weight loss gold rush.

Dr. Simond’s succinct comment:  “Diet is our most powerful tool.”  

Given his deep connections to the professionals in the obesity space, we asked how he would guess the majority of obesity practitioners might react to the proposition that exercise is healthier than weight loss when it comes to treating obesity.

Nine out of ten—90 percent—would say weight loss, he guessed.  

Drs. Gaessler and Siddhartha may have to roll their exercise ball up a steep incline as they conclude that “adherence to physical activity may improve if health care professionals consider physical activity and cardiorespiratory fitness as essential vital signs and then consistently emphasize to their patients the benefits in the absence of weight loss.”

If ninety percent think otherwise, in our sports space it reminds us of:

  • The western roll high jumpers who watched their world records fall to the back-asswards flops of Dick Fosbury.
  • The soccer playing Gogolak brothers whose sidewinder kicking style revolutionized football field goal scoring.
  • Bryson DeChambeau’s adaptation of golfing savant Moe Norman’s better way to hit a ball on the ground with a stick.

So, to the millions of SportsEdTV players who visit our pages regularly, here’s to your good health, you are great role models the couch potato world needs to copy. 

Thank you, and when you get a chance, enjoy a well-deserved donut, sundae or bagel.