Fitness may matter more than weight loss for health and longevity

December 28, 2021 — Numbers are easier. Perhaps that’s why a person’s weight – and millions of people’s desire to lose weight – is the number one talking point when it comes to health and longevity. Shortly after walking into your doctor’s exam room, for example, you’ll step on a scale. It’s usually the first measurement they take, before vital signs like blood pressure and heart rate.

It’s logic. It’s a number, which means it’s easy to see if your weight has changed one way or the other since the last weigh-in.

But there is an unexpected result: you go away thinking that your weight is just as important as the proper functioning of your heart and blood vessels, and that losing a few pounds will improve your health in a tangible and lasting way.

Yes, weight loss has proven health benefits. But should weight loss be the top priority for everyone classified as “overweight” or “obese” — a demographic that now includes three-quarters of all American adults?

“The weight loss message isn’t working and hasn’t worked,” says Glenn Gaesser, PhD, professor of exercise science at Arizona State University.

He’s one of a growing number of health experts who think losing weight may not be the most important benefit when it comes to living a healthier lifestyle. This is especially true if you compare it to the benefits of increasing your fitness level, as Gaesser and a co-author did in a recent study.

Intentional weight loss – that is, losing weight intentionally, rather than due to injury or disease – is generally associated in studies with a lower risk of death regardless of be the cause. The effect is strongest in people with obesity and/or type 2 diabetes.

But here’s an interesting wrinkle: the amount of weight lost does not seem to change the risk of dying. If the weight itself is the problem, why wouldn’t those who lost the most get the greatest risk reduction?

Gaesser is skeptical that the health benefits of weight loss are entirely or even primarily caused by a lower number on the scale. Many weight loss clinical trials — studies in which people participate in a structured program — also include elements of exercise and diet.

Moving more and eating better are consistently and strongly linked to a lower risk of death from any cause. And “the health benefits of exercise and diet are largely independent of weight loss,” says Gaesser.

This is especially true for exercising and living longer. Studies show that increasing physical activity reduces the risk of death from any cause by 15-50% and the risk of heart disease by up to 40%.

The change is even more dramatic when you train hard enough to improve your core shape. Moving from the lowest fitness category to a higher one can reduce your mortality risk by 30-60%.

The challenge of sticking to it

But here’s the catch: Exercise only helps if you do it, and a higher level of fitness works better if you maintain it.

“Adherence to exercise is just as difficult as adherence to diets,” says Gaesser. “I think one of the reasons is that exercise has been promoted primarily as a way to lose weight.”

It’s not that exercise doesn’t work at all if you’re trying to lose weight. According to a review of studies published in the 2010s, the average weight loss ranges from 3 to 8 pounds, mostly due to fat loss.

The problem is, the amount of weight you lose through exercise alone tends to be disappointing. Your body will compensate for much of the calories you burn during exercise (28%, according to one study) by slowing down your metabolism in other ways. Exercise can also increase your appetite, crushing all the calorie savings for a loop.

“If a person begins an exercise program with a particular weight loss goal, they will quickly see that there is a huge gap between ‘actual’ and ‘expected’ weight loss,” says Gaesser. “Most will give up in frustration.”

That’s why he says our best hope is that people finally realize how important movement is for long-term vitality, and that doctors and other healthcare professionals encourage their sedentary patients and clients to exercise. exercise for their health and for a longer life. Still, he acknowledges that exercise tends to be a tough sell once you take the promise of weight loss off the table.

If there’s one encouraging conclusion, it’s this: it doesn’t matter why you exercise, how you exercise, or if you don’t reach your goals.

“There are health benefits to putting in the effort,” Gaesser says. “Exercise has intrinsic value, regardless of changes in body weight.”

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