Interesting Read for Difficult Weight Loss Clients

[SFT]

http://onlinelibrary.wiley.com/doi/1...y.2007.164/pdf

Worth the read in my opinion. I know it is as easy to say weight loss comes down to calories in and calories out, but this paper focuses on compensation that could be occurring without a client even knowing. I had an idea about most of these hypotheses, but I hadn't seen the research presented this well before.

I thought the point on energy expenditure and energy intake in regards to the differences in time was particularly interesting. For example, assume it takes ~1 hour of exercise to burn 600 Calories. Our clients can go home and undo this in 2 minutes. I'm speaking very generally before anyone goes on about how they burn more than 600 Cals/hour, or about EPOC.

[rdferguson]

Your last paragraph just reminded me of the second time I did a crossfit workout. Oh Fran, you biotch. The results: couldn't finish the workout, shoulders were ruined for a week (as in ruined ruined, not sore deltoids), and the only thing that could bring me out of the deadzone afterwards was a massive slab of pizza and soft drink, which more than outweighed any calorie expenditure I got from the session.

Related to this (I haven't read the study yet, but I'm starting just now, so not sure if this is discussed at all), I've found that (as shown above) intense activity leads to intense eating, but low intensity activity doesn't rev up my appetite much, if at all, so, anecdotally, just being generally active without it being strenuous activity (stuff that probably won't even cause you to break a sweat) seems to be beneficial for creating a calorie deficit without driving me to feel the insatiable need to correct the deficit.

[acrawlingchaos]

Yes, your metabolism over time will compensate to a low intake/high out put. This isn't something that will be seen in your average weight loss clients. Compensation is something that will usually only apply to those who have been following VLCD diets, and compensation will occur in those that use excessive cardio.

LISS and MISS are cardio forms that will contribute to compensation. HITT does not appear to.




^^^^^ Does not apply to most (think yo/yo dieter, eating disorders, etc)

[SFT]

A few thoughts beyond that:

- There may potentially be metabolic and/or behavioral changes to exercise
- Metabolic would include RMR and energy expenditure changes from exercise
- Behavioral would include energy intake, exercise compliance, and spontaneous/other physical activity
- Behavioral responses will be more powerful than metabolic responses
- Behavior is ~20-60% of energy expenditure (exercise, physical activity), whereas behavior is 100% of energy intake (diet)

Consider this interesting example. If someone were to lose weight successfully, they could essentially gain it back over time through these compensations. On the metabolic side of things, RMR will decrease (probably not a whole lot), energy expenditure during non-exercise physical activity will decrease, and energy expenditure during exercise will decrease. If you couple this with any behavioral changes, such as snacking after a workout or not reducing caloric intake over time, you could essentially undo the initial weight loss.

- A behavioral compensation does not necessarily have to be deliberate (ex. small increase in meal size after exercise without recognizing it)
- A lack of weight loss in women has been associated with reduced energy expenditure, when being compared with men
- An individuals metabolic and behavioral responses to exercise will determine their success with a weight loss program
- A person might think they can reward themselves with a snack or rest for a hard workout, thus increasing energy intake or reducing energy expenditure
- Some studies have shown a loose coupling between energy expenditure (through exercise) and energy intake (kind of going against the idea above)
- Another series of studies showed a slight compensatory increase in energy intake in women only (7 day intervention)
- At 14 day intervention, 30% of exercise induced energy expenditure was negated by increased energy intake

- There is some evidence to suggest that non-exercise physical activity is reduced in response to exercise (fatigue?). On the other hand, there have been studies that have show a net increase in energy expenditure in resistance training with elderly folks, and aerobic training with younger populations.
- There is some possibility that exercise could increase non-exercise physical activity energy expenditure due to people feeling more healthy and participating in more activities
- Exercise induced energy expenditure is associated with weight loss. Men tend to have greater EE from exercise than women, more potential for weight loss.

- People respond differently to exercise (I know that this is a ground breaking finding...) However, you might take a look at the graphs presented just to see how big of a difference there can really be to a similar intervention.
- "Compensators" will increase Caloric intake, while non-compensators will maintain a relative stable Caloric intake despite increases in exercise intensity

Please take care in that each of these points is merely my interpretation, or notes, from reading the research. These are not set in stone rules, but merely ideas. Some of these we can be more certain of than others.

My take home points
- Everyone responds differently to exercise
- Clients may present with behavioral compensations to exercise either knowingly or unknowingly. Some education here might be important.
- If our clients are very fatigued, they might be more likely to sit around on the couch than be up and moving. They might skip the steps and opt for the elevator.

Questions I'm left with
- Do people that respond poorly to one type of exercise respond poorly to others? For example, aerobic exercise versus strength training.

[rockangel]

I read the research and found it interesting. However, i think the percentage of people whose bodies would be compensating unknowingly would be very small. As in, barring any physical or medical deviation, the science of the body is the same.

I do agree that people will knowingly or unknowingly eat more than they are expending during exercise, and i find this to be true no matter the intensity. The average person just doesnt know or realize the importance of nutrition in the weight loss equation.

I generally dont think that there are people out there who will not respond to any form of activity. Thats not really how our bodies are "made". So a person who may not do well on Liss, may do better on Hiit (personally i find this to be true for myself), or a person who is not a strong runner, may be better at strength training. Now thats just my experience talking and i have no studies to back that up.

[SFT]

Yes, your metabolism over time will compensate to a low intake/high out put. This isn't something that will be seen in your average weight loss clients. Compensation is something that will usually only apply to those who have been following VLCD diets, and compensation will occur in those that use excessive cardio.

LISS and MISS are cardio forms that will contribute to compensation. HITT does not appear to.




^^^^^ Does not apply to most (think yo/yo dieter, eating disorders, etc)

The compensations you seem to be speaking about are to RMR. This article also talks about changes in energy expenditure of exercise due to changes in weight, as well as behavioral changes too.

Do you mean that LISS and MISS will change RMR and HITT will not?

My main thoughts with this article are application to difficult weight loss clients. There are certainly many clients that respond well to exercise and the most basic of diet interventions.

[RevolutionFF]

I haven't got time to read this atm, but will do later.

Whilst calorie intake is important and will determine your results ultimately, it is your hormonal balance that will also determine results and calorie intake to some degree.

Try eating purely sugar all day and nothing else - you will have energy crashes, poor mood, more cravings etc. Your hormonal balance will be shot to bits, and long term results will not happen.

Certain exercise modes will also increase hunger - which is not great during a fat loss period.

[rockangel]

I haven't got time to read this atm, but will do later.

Whilst calorie intake is important and will determine your results ultimately, it is your hormonal balance that will also determine results and calorie intake to some degree.

Try eating purely sugar all day and nothing else - you will have energy crashes, poor mood, more cravings etc. Your hormonal balance will be shot to bits, and long term results will not happen.

Certain exercise modes will also increase hunger - which is not great during a fat loss period.

I hate arguments like this. Eating pure sugar all day is not likely going to happen. It would be extremely difficult to do. Now someone can have a bad diet where they eat a lot of products with sugar, but the "hormones" are not going to be what is keeping them fat/unhealthy. It will be just the fact that their diet is bad. Change their diet, and they lose weight.

So the whole "eat nothing but sugar" argument is just a theoretical argument, and does not apply to the real world, as no one is going to eat "pure sugar" all day and nothing else.

And the people with legitamite hormonal imbalances, again with be a very small percentage of the population, much less than what is claimed.

And this is coming from someone who has some screwed up hormones, diagnoesd by a doc at age 5.

[RevolutionFF]

I hate arguments like this. Eating pure sugar all day is not likely going to happen. It would be extremely difficult to do. Now someone can have a bad diet where they eat a lot of products with sugar, but the "hormones" are not going to be what is keeping them fat/unhealthy. It will be just the fact that their diet is bad. Change their diet, and they lose weight.

So the whole "eat nothing but sugar" argument is just a theoretical argument, and does not apply to the real world, as no one is going to eat "pure sugar" all day and nothing else.

And the people with legitamite hormonal imbalances, again with be a very small percentage of the population, much less than what is claimed.

And this is coming from someone who has some screwed up hormones, diagnoesd by a doc at age 5.

Of course it's hypothetical - I dare anyone to try and eat 2000 cals from purely sugar a day! But it is similar to how many people will eat in terms of effect on hormones - carbohydrate laden breakfast, with little to no protein, a big carbohydrate based lunch in the form of potatos, pasta or sandwiches with a little protein and a carb heavy dinner.

Yes, by cleaning up your diet you will lose weight - as your hormonal balance improves. That is a side effect of improving your nutrition. Willpower vs hormones - hormones will win hand down. If you are hungry all day every day, because of a low calorie diet, poor exercise choice and poor macronutrient ratios, you will eventually succumb the the inevitable binge.

Insulin, leptin, ghrelin, CCK, PYY, GIP, GLP etc. All the hormones that will effect satiety, blood sugar levels, energy etc.

Not just the generic 'blame it on your hormones' mambo wambo.

[rockangel]

Of course it's hypothetical - I dare anyone to try and eat 2000 cals from purely sugar a day! But it is similar to how many people will eat in terms of effect on hormones - carbohydrate laden breakfast, with little to no protein, a big carbohydrate based lunch in the form of potatos, pasta or sandwiches with a little protein and a carb heavy dinner.

Yes, by cleaning up your diet you will lose weight - as your hormonal balance improves. That is a side effect of improving your nutrition. Willpower vs hormones - hormones will win hand down. If you are hungry all day every day, because of a low calorie diet, poor exercise choice and poor macronutrient ratios, you will eventually succumb the the inevitable binge.

Insulin, leptin, ghrelin, CCK, PYY, GIP, GLP etc. All the hormones that will effect satiety, blood sugar levels, energy etc.

Not just the generic 'blame it on your hormones' mambo wambo.

But the hormones are not "imbalanced" due to the body producing/not producing needed hormones that would affect weight loss. Any change in hormones is attributed to food choices that can be changed by the individual.

A true "hormonal imbalance" that would affect the gain/loss of weight, muscle or fat would be the body producing or not producing a hormone that would specifically be needed for these things. It would be something beyond the control of the individual that would require a doctor diagnosis and treatment. If a person is eating a bad diet and then changes said diet and loses weight, then they did not have a true hormonal imbalance causing their inability to lose weight.

Yes hormones are important, but actual hormonal imbalances that would affect a person's weight loss are going to be a small percentage, and those people would not be helped by a personal trainer, but need specialized care.

The vast majority of individuals who find it hard to lose weight are either knowingly or unknowingly causing their issues, which is what the article states.

[rockangel]

This is what I am talking about. This would be a true hormonal imbalance which affects the body composition of an individual. Again, it is considered a rare disease by the cdc, so not many people would present with this.

Adults with growth hormone deficiency may have any of the following symptoms:
 More fat in their bodies
 Less muscles, strength, or energy
 Poor sleep
 Weaker bones
 High cholesterol levels
 Thin, dry skin
 Emotional symptoms such as depressed mood or social withdrawal

Recently, several studies have shown that GHD in adults is associated with abnormalities in body composition (6–14), metabolic derangements (15–17), and suboptimal physical performance (18–20).

But, take a look at my stats and guess who was diagnosed with this at age 5 and put on HGH injections.

But, like i said, in reality, this would not be the case for many people, or even people who may be shorter. This would need to be medically diagnosed and treated and personal training is only going to be able to go so far, even for myself.

[My Own Summer]

interesting stuff but I have to run to work!! Checking back later.. good discussion!

[RevolutionFF]

Yes, I agree with 'actual' hormonal deficiencies - whereby you are not creating enough of a hormone as you described. Growth hormone, insulin (Type I diabetics), androgen imbalances etc.

What I am on about, is hormonal imbalances caused by a lack of (quality) exercise and poor nutrition choices. The cause is poor nutrition and exercise, and the symptoms are weight gain, poor mood, lack of energy etc.

Take for example the classic case of insulin resistance. Some people are more predisposed to this problem and will quickly see weight gain by consuming too many carbohydrates. Others, for some reason (maybe genetic) are able to eat what they like and not have the massive spikes in insulin that your overweight person may have. Is it the weight gain causing insulin resistance? Is it genetic? Is it insulin resistance causing weight gain? You can never be 100% sure of the causative factors. I would take an educated 'guess' that poor food choices can be related to large number of insulin related weight gain cases.

The same can be said for leptin and poor food choices/constant overeating. Even testosterone:estrogen imbalances caused by lack of muscle mass, poor detox pathways, too much alcohol, too much junk food and an ever more estrogen dominant environment.

These are not hormonal problems you should be born with, but can be predisposed to - maybe genetics as I said, or simply the way that your mother eats during pregnancy - but that's something far deeper and far beyond my scope.

I believe that a properly nourished body, with proper exercise prescription will cure a lot of people.

[SFT]

I read the research and found it interesting. However, i think the percentage of people whose bodies would be compensating unknowingly would be very small. As in, barring any physical or medical deviation, the science of the body is the same.

I believe this statement to be untrue. In the most simple terms you could say that basic bodily processes occur in most health individuals. Beyond that, you have to wonder why there is so much individual variation if the science of the body is the same. Some of these studies have suggested considerably different responses to exercise. Some people showed an increase in RMR in response to aerobic exercise, others showed a decrease, and many people showed little change.

Also, if you look at one of the graphs of compensators vs. non-compensators to exercise, it is clear that on one end people increase caloric intake, while the other group of people was relatively steady.

There also appears to be considerable differences with women. If the science of the body was the same and hormone or other influences were negligible, coupled with compensations, both behavioral and metabolic, we wouldn't expect to see differences in weight loss across the spectrum.

If you read the paper, I find it hard to doubt that compensation happen in response to exercise and/or weight loss. If you lose weight, you will use less energy for day to day tasks. In the case that there is any doubt about this, try to wear a 40lb. weight vest all day. Likewise, RMR and exercise energy expenditure will decrease with weight loss if all things are equal.

I think the question isn't as much about applying this to clients that respond well, but using some of this information for difficult clients. The type of people who say that they have considerable difficulty losing weight. We can't simply call them lazy and assume that they are intentionally sabotaging their progress with poor nutrition.

[RevolutionFF]

I believe this statement to be untrue. In the most simple terms you could say that basic bodily processes occur in most health individuals. Beyond that, you have to wonder why there is so much individual variation if the science of the body is the same. Some of these studies have suggested considerably different responses to exercise. Some people showed an increase in RMR in response to aerobic exercise, others showed a decrease, and many people showed little change.

I'm loving this topic thread. Really interesting conversation.

The above is something we learnt about at university - responders and non-responders. Must be down to different genes.

[rockangel]

I believe this statement to be untrue. In the most simple terms you could say that basic bodily processes occur in most health individuals. Beyond that, you have to wonder why there is so much individual variation if the science of the body is the same. Some of these studies have suggested considerably different responses to exercise. Some people showed an increase in RMR in response to aerobic exercise, others showed a decrease, and many people showed little change.

Also, if you look at one of the graphs of compensators vs. non-compensators to exercise, it is clear that on one end people increase caloric intake, while the other group of people was relatively steady.

There also appears to be considerable differences with women. If the science of the body was the same and hormone or other influences were negligible, coupled with compensations, both behavioral and metabolic, we wouldn't expect to see differences in weight loss across the spectrum.

If you read the paper, I find it hard to doubt that compensation happen in response to exercise and/or weight loss. If you lose weight, you will use less energy for day to day tasks. In the case that there is any doubt about this, try to wear a 40lb. weight vest all day. Likewise, RMR and exercise energy expenditure will decrease with weight loss if all things are equal.

I think the question isn't as much about applying this to clients that respond well, but using some of this information for difficult clients. The type of people who say that they have considerable difficulty losing weight. We can't simply call them lazy and assume that they are intentionally sabotaging their progress with poor nutrition.

What I mean is that, generally, an overweight or obese person is going to lose weight by reducing calories and adding a bit of exercise. The majority of people will not have a factor that is limiting them in losing weight, though we see a high percentage of people claim the opposite.

For instance, i recently sat at a meeting where one woman told the group that she was on the "HCG" diet and this was prescribed by her doctor. She claimed that the doc told her she was producing too much estrogen, that her hormones were out of whack, and that by taking the HCG she was brining her estrogen down. She claimed to be eating only 500 cals a day and most of that was carbs or fat with little protein (according to her). Now what i find crazy about this is that HCG is a fertility drug and is only allowed by the FDA to be used for that purpose. This lady had three kids under 6, so i doubt there was a fertility issue. I would also say she was 45- 50% bf, and we know that having a lot of adipose tissue creates more estrogen. She had dropped 26 pounds in 2 months, now was she losing the weight because she was eating 500 cals, or because she was "balancing" her hormones.

ETA: this lady claimed she was a "hard loser" and that no exercise or diet that she had tried worked.

[pcproffy]

I've found that (as shown above) intense activity leads to intense eating, but low intensity activity doesn't rev up my appetite much,

Intense activity will drop your blood sugar faster which = hunger. Less intense lets your body use fat and maintain more even blood sugar levels. This is where a gatorade type drink during your workout or getting carbs ASAP post workout can moderate the effect and prevent over-eating afterwards.

Personally, I love the intense hunger. In my experience it means I'm putting in serious work and it justifies food that's needed to satisfy the hunger. When I get that super hunger I'm never putting on fat even when it feels like I'm eating like a horse. Can't guarantee the general public reacts the same way.

[BernadetMatassa]

Great blog. Looking forward to read more.

[pcproffy]

What I mean is that, generally, an overweight or obese person is going to lose weight by reducing calories and adding a bit of exercise. The majority of people will not have a factor that is limiting them in losing weight, though we see a high percentage of people claim the opposite.

For instance, i recently sat at a meeting where one woman told the group that she was on the "HCG" diet and this was prescribed by her doctor. She claimed that the doc told her she was producing too much estrogen, that her hormones were out of whack, and that by taking the HCG she was brining her estrogen down.

now was she losing the weight because she was eating 500 cals, or because she was "balancing" her hormones.

ETA: this lady claimed she was a "hard loser" and that no exercise or diet that she had tried worked.

First off, it's a total BS story with the HCG, as it INCREASES estrogen/estradiol and progesterone in women. HCG acts as LH and FSH in the body. Now in men real HCG (not homeopathic BS) will make a difference because mimicking LH+FSH leads to higher TEST which will naturally lean them out.

Anyone will lose weight on 500 calories regardless of HCG and we all know it. Just like every other weight loss gimic that also fine prints "following a sensible diet and exercise plan is recommended". The common theme between them all is the diet and exercise part, no wonder it works!

[rockangel]

First off, it's a total BS story with the HCG, as it INCREASES estrogen/estradiol and progesterone in women. HCG acts as LH and FSH in the body. Now in men real HCG (not homeopathic BS) will make a difference because mimicking LH+FSH leads to higher TEST which will naturally lean them out.

Anyone will lose weight on 500 calories regardless of HCG and we all know it. Just like every other weight loss gimic that also fine prints "following a sensible diet and exercise plan is recommended". The common theme between them all is the diet and exercise part, no wonder it works!

I know HCG is complete crap, but i was using her as an example because this conversation happend about 2 weeks ago. She went on and on about how her hormones are screwed up and she has never been able to lose weight and how she finds it incredibly hard to lose weight. Making her one of those clients that we are discussing in this thread.
My point being that lots of people SAY that they have hormonal imbalances that are causing them to be unable to lose weight. I realize its the 500 cals that are causing her weight loss which means that if she were to actually diet correctly and exercise (she said she did not have time to exercise with 3 young kids, so all weight loss was diet related) she would be dropping the weight. Her hormones were not being treated by an endo with specific medications, nope, she was put on HCG.

And please dont get me started on my friend who claims her birth control has her hormones screwed up and thats why she cant lose, all the while eating an entire rottissere chicken that she pours a ton of salt on each bite.

So, my experience tells me that the population that ACTUALLY has an unkown factor limiting weight loss will be quite small.

[Footballa_19]

Great read, informational, with educated and intelligent responses. Great input from everyone, I think ill read em all again.

[SFT]

I know HCG is complete crap, but i was using her as an example because this conversation happend about 2 weeks ago. She went on and on about how her hormones are screwed up and she has never been able to lose weight and how she finds it incredibly hard to lose weight. Making her one of those clients that we are discussing in this thread.
My point being that lots of people SAY that they have hormonal imbalances that are causing them to be unable to lose weight. I realize its the 500 cals that are causing her weight loss which means that if she were to actually diet correctly and exercise (she said she did not have time to exercise with 3 young kids, so all weight loss was diet related) she would be dropping the weight. Her hormones were not being treated by an endo with specific medications, nope, she was put on HCG.

And please dont get me started on my friend who claims her birth control has her hormones screwed up and thats why she cant lose, all the while eating an entire rottissere chicken that she pours a ton of salt on each bite.

So, my experience tells me that the population that ACTUALLY has an unkown factor limiting weight loss will be quite small.

Just so I know where you are coming from, how many clients have you worked with? What do you consider good progress to be? Do you ever have people who legitimately find it difficult to lose weight and keep it off long-term? I am speaking in terms of years and not months. The reason I ask is because I worked in a bootcamp where we would regularly perform an assessment including weight, waist/hip, and bodyfat caliper. What I find is some people didn't make progress (probably compensatory eating habits, or perhaps not following basic diet advice) or would make progress for some period of time, but then stall far short of figure competitor status.

If weight loss was as simple as reducing calories and increasing physical activity, we would have lean people everywhere. Walk around any gym and you will see that this is not the case.

[foodandfitness]

OP, Great read. Thank you for posting.

Here are my personal conclusions drawn from this article:
Exercise has many variables that either make it effective or ineffective for weight loss. We can't quantify how much and for who, but we know it is a factor. Because of this fact, and a large body of research suggesting that dietary intervention is more effective than exercise alone on weight loss, that nutrition should be the most emphasized part of weight loss.
Exercise is more important for determining the ratio of fat loss and muscle preserved. Choosing exercise routines that maximize muscle preservation (heavy lifting) is what I use for my clients whenever possible.


Last time I checked weight loss is achieved by creating a calorie deficit. This is best done with dietary interventions.

I have yet to see one client that can not lose weight by creating a calorie deficit with their diet. I've had insulin resistant, diabetic, thyroid disorders (controlled with medication), thyroidectomy patients, men, women, obese, old, young, low testosterone, etc. etc.

[rockangel]

Just so I know where you are coming from, how many clients have you worked with? What do you consider good progress to be? Do you ever have people who legitimately find it difficult to lose weight and keep it off long-term? I am speaking in terms of years and not months. The reason I ask is because I worked in a bootcamp where we would regularly perform an assessment including weight, waist/hip, and bodyfat caliper. What I find is some people didn't make progress (probably compensatory eating habits, or perhaps not following basic diet advice) or would make progress for some period of time, but then stall far short of figure competitor status.

If weight loss was as simple as reducing calories and increasing physical activity, we would have lean people everywhere. Walk around any gym and you will see that this is not the case.

I have not been training as long as some here, so obviously there are others who have been training for decades and have loads more experience. I also believe that i have said that I am drawing from my own experiences and have no studies to post.
However, everyone i have trained so far has had success in loseing weight, with the exception of one. That paricular person was involved in binging and abuse of laxatives, and apprently had been for some time, although they were heavily obese. Obviously more wrong there than just "hard to lose" and beyond the scope of my abilities (or anyone here, assuming you are not a MD)

However, for every one person i train to success, i have at least 6 others telling me how hard it is for them to lose, their bodies are just made to be fat, they have hormone, thyroid issues, and nothing works. These are the people i dont end up training, because they are soooooo certain in their mind that they cant so they never try. And here recently this trend has gotten worse as I am introduced to new people (just moved), i am inevitably introduced as "this is angel and she is really into fitness" the conversation then turns into how lucky i am to be "skinny" and how one of the above applies to my new companion.

If it were purely a genetic component then i would be screwed as not only do both my brother and I both have doctor diagnosed hormonal deficiences, every single female on both sides of my family are obese!!! (most of whom have bad diets, but make the same above excuses) Do i find my rate of fat loss or muscle gains slow by comparing me to others who have similar stats and started at the same time i did, absolutely. But that does not mean that i have NO success, only that its different. So yeah, there will be people out there who gain or lose /muscle and fat at different rates, but thats a gimme, a no brainer.

You also have no idea how long i have been dealing with this in the animal world, a rancher by family trade, I have prepped animals for market and show ring since I was 12. The Same principles apply to all animals no matter if its cow, sheep, pig, rabbit, goat, horse or human.
Increase work decrease food = weight loss
Decrease work Increase food = weight gain
The way you control that is through macro manipulation (and in the show ring, water manipulation)
You would be suprised at how many parallels there are to the bodybuilding world in the market/show world.

Many of the same thing can be said of a sheep or cow, there are hormonal differences in each individual as well as gentic components. Individuals in a herd will gain or lose muscle at differing rates based on those differences. The only difference between a herd of cattle and a herd of humans, is the cows dont know about hormonal imbalances, or genetics, or calories. Yet the entire herd will lose weight when faced with decreased food intake. No one cow is obese while the others are all rib racked.

By and large my experience is that most individuals do NOT present with limiting factors, of those that will, it may be slower rate of loss than some, but a rate of loss is still progress. Of those with true limiting factors, many can be dealt with by seeking proper care (thyroid medication for a thyroid, insulin for a diabetic, etc etc)

OP, Great read. Thank you for posting.

Here are my personal conclusions drawn from this article:
Exercise has many variables that either make it effective or ineffective for weight loss. We can't quantify how much and for who, but we know it is a factor. Because of this fact, and a large body of research suggesting that dietary intervention is more effective than exercise alone on weight loss, that nutrition should be the most emphasized part of weight loss.
Exercise is more important for determining the ratio of fat loss and muscle preserved. Choosing exercise routines that maximize muscle preservation (heavy lifting) is what I use for my clients whenever possible.


Last time I checked weight loss is achieved by creating a calorie deficit. This is best done with dietary interventions.

I have yet to see one client that can not lose weight by creating a calorie deficit with their diet. I've had insulin resistant, diabetic, thyroid disorders (controlled with medication), thyroidectomy patients, men, women, obese, old, young, low testosterone, etc. etc.

In shorter more concise words, this ^^^^^^.

[acrawlingchaos]

Difficult clients are difficult because they are non compliant. It is a RARE occurrence when someone can not lose weight because of some "true" compensatory reason.

. The only time I would look at compensatory adjustment to cardio, is someone who has done A LOT of cardio.

. The only time I would look at compensatory adjustment to intake, is when someone used a VLCD over a long period of time (6 months plus), or with someone who is at a low bf level already.

. Hormones (most markers) should improve as you lower weight, not the other way around.

As far as compensatory eating habits, this isn't a condition, it's common sense. You move more, your body wants more food. This happens to EVERYONE, not just a select few. Most people fail or spin their wheels because they either have the training in check or the diet.... but not both. Noncompliance.

[SFT]

I want to be clear to make the point that these compensations are not excuses or medical problems. I do not want to suggest that most people that walk into the gym are unable to lose weight. On the other hand, I do want to suggest that we can't chalk up every difficult client to noncompliance, at least in a traditional "lazy client" sense.

Energy balance = Energy intake - Energy expenditure

Energy expenditure = RMR + Exercise Energy Expenditure + Non-exercise Energy Expenditure

I am not refuting these general equations and I think we can all agree so far. If your energy balance is negative, you should lose weight in theory. I have a hard time making any absolute statements when it comes to a system as complex as the human body. I might be suggesting that based on the article, perhaps we oversimplify energy intake and even ignore influence of exercise on non-exercise energy expenditure.

I need to read the article that is presented in this study for more information, but if you see Figure 5 in the article, there are clearly people who were found to increase caloric intake in response to increased activity, and another group that did not. This is an interesting find to me. I will be interested to see based on the study what the group sizes are like.

I do agree in most cases that dietary interventions are going to lead to weight loss. The findings in this study are probably most important to solidify the need for dietary interventions, especially for those who think they are going to get by with exercise alone. As food and fitness said, exercise should be important in the quality of weight loss. I want to see my clients losing as much fat and as little lean mass as possible. Resistance training is certainly important to this end.

Unfortunately I always post minutes before I need to leave, so I wasn't able to finish my thoughts completely, but this has been a pretty interesting discussion. You can always argue that people are overcomplicating things, but I don't think that weight loss is always so simple.

[acrawlingchaos]

The abstract clearly states that there two distinct types of compensatory reactions;

. Obligatory (that we can't control).

. Facultative (that we can control).



Intention compensation is just that, intentional i.e. non-compliant.

Obligatory responses occur from either an acute deficit (sudden and steep), or from a prolonged and excessive diet/training regiment. If you have a "difficult client" either they are not following your instructions, or your protocols are excessive.

Part of the compensation (which wasn't discussed in the study), is the normal compensation that occurs through SAID. The more you do aerobics, the better your body comes at utilizing more oxygen for energy. For this reason, I personally only believe cardio should be used for heart health reasons, not for the purpose of improving composition.

[SFT]

The abstract clearly states that there two distinct types of compensatory reactions;

. Obligatory (that we can't control).

. Facultative (that we can control).



Intention compensation is just that, intentional i.e. non-compliant.

Obligatory responses occur from either an acute deficit (sudden and steep), or from a prolonged and excessive diet/training regiment. If you have a "difficult client" either they are not following your instructions, or your protocols are excessive.

Part of the compensation (which wasn't discussed in the study), is the normal compensation that occurs through SAID. The more you do aerobics, the better your body comes at utilizing more oxygen for energy. For this reason, I personally only believe cardio should be used for heart health reasons, not for the purpose of improving composition.

Does the fact that we can control them mean that we are intentionally being non-compliant? If I opt for the elevator at work after a hard leg workout, am I intentionally thinking to myself: "I am being non-compliant and creating an unfavorable energy balance by reducing my non-exercise energy expenditure?" What about if I gradually add a little more food to my plate without noticing over time? I would believe that I can control this, but if I don't know that it is happening, I would not call it intentional.

Metabolic responses can occur in response to weight change. If you lose weight your RMR should decrease. While this might be due to prolonged diet, it is also because you lost weight. Likewise, after weight loss you will burn fewer calories from both exercise and non-exercise activities if all other variables are held equal. I make this point because these are obligatory responses that occur from neither an acute deficit, nor prolonged or excessive diet/training. That is why I suggested that if you lose weight and fail to make changes to your program, you could potentially gain it back.

Energy balance = Energy Intake - Energy Expenditure (RMR + Exercise + Non-Exercise PA)

If you lose weight, the whole right side of our equation (energy expenditure) decreases unless you make changes. This could be in the form of increased frequency, intensity, or duration of exercise. Alternatively, you could continue to reduce the left side of the equation (energy intake).

The last part of your post about SAID is interesting. If you were to plot HR and VO2 on a graph, after training, if I am not mistaken, you would see a shift of the curve to the right whereby you would achieve a higher VO2 at the same HR. Is oxygen consumption not an indirect measure of energy expenditure? If it is, would utilizing more oxygen not be a good thing?

I would agree with you if we were to hold the treadmill speed steady at say 6.0 mph. After adaptations and weight loss, you would burn fewer calories at the same speed. More than anything, this would likely be a result of increased efficiency of movement, as well as decreased weight, which directly affects energy expenditure in weight bearing exercise. This point being made, do you often see people not progress the intensity of exercise over time? Perhaps you now run on the treadmill at 7.0 mph, you are exercising at the same heart rate, and therefore you have increased a combination of your VO2 at that heart rate, as well as your efficiency of jogging.

[acrawlingchaos]

Sure, we may subconsciously start eating more. The first question I will ask is "Are you counting calories? Weighing and tracking everything?". This will be my very first response EVERY TIME. If they are not, well.... then we have no clue. If they are, are they doing it correctly? So compensational feeding can be avoided with accurate measuring and weighing of food (which IMO, every "fat loss" client should be doing).

Behavioral compensation (fatigue) is typically a sign of too steep of a deficit. As a trainer, this is a clear indication that calories are too low, and exercise is too steep. If there is no deficit (i.e. not losing weight) than the fatigue isn't diet related (most likely above our scope of practice).

The RMR decrease associated with the general loss of mass is insignificant. Take your novice client, where some recomp is inevitable (muscle gain), you will see a net change of probably nothing in RMR.

Muscle tissue = 7 calories per pound per day maintenance.
Adipose tissue = 2 calories per pound per day maintenance.

If an obese client of 250 pounds, lost 50 pounds of fat and gain 5 pounds of muscle (which is likely in an obese client), rmr decreases by a measly 100 calories from fat loss, and increase 35 from muscle gain... this is a change in only 65 calories a day.

If you have clients that ARE accurately counting over time, and are doing a lot of cardio, without losing weight on a VLCD then I would look into physiological obligatory compensations. In this case, reverse dieting to restore metabolic efficiency would be the wisest move (but WILL require counting).

[SFT]

Sure, we may subconsciously start eating more. The first question I will ask is "Are you counting calories? Weighing and tracking everything?". This will be my very first response EVERY TIME. If they are not, well.... then we have no clue. If they are, are they doing it correctly? So compensational feeding can be avoided with accurate measuring and weighing of food (which IMO, every "fat loss" client should be doing).

Behavioral compensation (fatigue) is typically a sign of too steep of a deficit. As a trainer, this is a clear indication that calories are too low, and exercise is too steep. If there is no deficit (i.e. not losing weight) than the fatigue isn't diet related (most likely above our scope of practice).





If you have clients that ARE accurately counting over time, and are doing a lot of cardio, without losing weight on a VLCD then I would look into physiological obligatory compensations. In this case, reverse dieting to restore metabolic efficiency would be the wisest move (but WILL require counting).

Do you have any sources for those RMR values? I'd be interested in reading more. I certainly don't think changes in RMR are making or breaking a client's progress, but they are occurring.

As far as weighing food, I don't find it to be practical for most people. You might say progress could be limited by not doing it. I might agree with you there. However, it is difficult to even get some people in the gym, let alone have them slaving away in the kitchen weighing their food.

To me, there is quite a bit of potential error in both calculating energy expenditure and energy intake. From what I remember reading, the information on nutrition labels is no longer directly measured. I'm not fully familiarized with the process, but there does seem to be room for error. Also, many people calculate based on how many calories a certain food should have. However, with different brand names, species types, and other factors, I wonder how accurate these numbers really are? I would be interested in learning more regarding individual differences in how much energy is actually derived from a food. If you and I eat the same size potato, how much difference will there be in the actual absorption of the nutrients?

Perhaps the error involved in both sides, energy intake and energy expenditure is negligible. I cannot say that for sure. As overused of a phrase as it might be: "the more I learn, the less I know".