Podcast review: “What the fitness industry gets wrong about the obesity epidemic”— Iron Culture Podcast episode #146, featuring Dr. Gabrielle Fundaro and Dr. Ben House
“You can find a study to support anything.” This is a phrase heard often during debates surrounding health and fitness. If you’re searching for answers as to how to improve some aspect of your health, there is no shortage of information on the internet. If your job and your livelihood doesn’t require you to objectively analyze this data, it can be downright overwhelming to know who to trust. Should you eat low carb or low fat? Should you run or lift weights? Which fitness influencer is actually trying to help, and who is just trying to sell you something?
Your coaches at Paragon pride themselves on taking an evidence-based approach to health and fitness. This requires us to stay up to date on recent research as well as being able to identify high quality sources of information in order to establish best practices in helping you towards your goals. We started the Fitness Podcast Review series as a way to help you sift through the noise and provide you with resources which are both relevant to your goals as well as high quality in terms of integrity and approach.
Come As You Are.
- Our modern world is such that highly palatable, calorie-dense foods are more available than ever before: A Honey Bun can be purchased at most gas stations for around $1, providing around 250 calories and close to 1/3 of the recommended daily intake for both sugar and saturated fat.
- Rather than our jobs being physical in nature, “going to work” often consists of rolling out of bed and logging onto a computer, or sitting at a desk in an office. The average American gets fewer than 5,000 steps per day, making us one of the most sedentary countries in the world.
So we’re less active than ever before, and have more access to delicious and highly caloric foods than ever before.
And yet, we live in a society where searching for the term “fitness” in Instagram leaves you with:
As humans we are genetically driven to store excess energy (calories) in order to survive during periods of famine, and our modern world is set up for us to do this quite efficiently. It is only over the last 100 years or so that society has created a stigma around excess weight. Many people we meet as coaches are afraid of adding muscle (let alone fat) when they begin to exercise, a clear sign that society has created constant pressure to become smaller- to restrict our intake and subtract from our body size in order to feel accepted.
The system is broken. Picture the following scenario:
A woman in her 50’s joins a gym and starts working with a personal trainer. She tells the trainer that she wants to lose 10 pounds. The trainer puts her on a workout program which calls for her to workout 5x/week and cut carbs out of her diet. The woman sees some great initial success, and by her third month she’s lost the 10 pounds she initially set out to lose. For some reason, she’s still not satisfied with how she looks. She sets a new goal of getting back down to what she weighed in high school which means another 10 pounds of weight loss. Three months later she gets back on the scale and has only lost 2 pounds. Now she is frustrated, embarrassed, and still hates the way she looks. Not to mention, she’s exhausted by the strenuous protocol it took to get there.
If you’re reading this blog, you’ve likely either been through a similar process yourself, or you know someone who has. This process of yo-yo dieting and exercise aimed at weight loss tends to play itself out in a very similar manner over and over again. In fact, research suggests that diets aimed at weight loss are almost always unsuccessful long term. Depending on the study, anywhere from 80 to 95% of people who lose weight on a diet will regain 100% of the weight lost within a 3 year period. As a new client recently quipped, “I’ve been losing the same 15 pounds every year for the last decade.”
Recently, two experts in the field of health and nutrition, Dr. Gabrielle Fundaro and Dr. Ben House, were on the Iron Culture podcast discussing the merits of weight loss and dieting. I’d highly recommend listening to the whole episode by clicking here, but I’ve given my thoughts below:
Takeaway point #1: Weight loss vs. Behavior change
A major point of emphasis for both guests was making a distinction between intentional weight loss versus weight loss which happens as a result of modifying behavior. When weight loss happens almost “accidentally,” as a result of a client taking steps to become healthier in general, it tends to be both more satisfying and more sustainable long term. If we can move away from thoughts of “how little do I need to eat in order to keep losing weight?” or “how many calories do I have to burn today in order to work off that burger and fries?” I think outcomes are going to be more favorable long term.
Let’s replace those “avoid” strategies with “approach” versions:
- Instead of “how little do I need to eat,” ask yourself “how can I add more nutrients to my day?” or “What steps can I take to be healthier overall?”
- Instead of “How many calories do I need to burn in my workout,” ask yourself “How can I take steps towards making myself stronger today?”
Takeaway point #2: Come As You Are
In the earlier example, what was the trainer’s biggest mistake? Should he have given her a 7 day per week program? Fewer calories? Sold her a juice cleanse?
I’d argue that the program doesn’t matter. The trainer never bothered to ask the most important question: Why? Why do you feel you need to lose weight?
Another important question not asked often enough: Are you approaching this goal from a place of self-compassion?
This may sound touchy-feely, but if the reason you want to lose weight is because you think weight loss will be a solution for your happiness, you’re setting yourself up for failure.
This is the narrative that we need to change quickly. I used to be the type of coach who would listen to his clients’ goal, take it at face value, and help them do whatever it is they said they wanted to do. Want to lose 50 pounds in 6 months? Want to lose 5 dress sizes? Okay, that’s your goal so let’s get after it.
Earlier in my career, I didn’t give enough credence to understanding the “why.” Do you want to lose this weight because your doctor told you that you need to? Because your friends are all thin and you think they judge you based on your weight? Because you want a closer relationship with your spouse? The answers to these questions could all potentially point us in different directions when it comes to determining the best course of action for you.
I’ll never be that kind of coach again. Don’t get me wrong, I am not here to talk anyone out of their goals. However, if weight loss is your number 1 goal, we will not start working together until I have a very good understanding of why it’s your goal and I’m going to make damn sure you know that you do not have to lose weight. It’s completely normal to identify things about yourself that you want to improve, and then set out to change those things. It’s a different story when you start to tie your identity and your self worth to what you look like or how much you weigh.
One thing that helps make Paragon different from other gyms is that we accept you for who you are. You are capable of being healthy at any size, any shape, any weight. The fact that as a society we’ve tied morals into body size and body shape is a shame, and isn’t helping anyone.
Takeaway point #3: Healthy at any weight
There is plenty of evidence to suggest that weight loss, or achieving some “ideal” body size and shape is completely unnecessary when it comes to improving health. We’re told over and over again that this country has an obesity epidemic. I’d argue that we actually have a narrative problem, where people who are “overweight” or those categorized as obese are blamed for draining the health care system. But is there actually evidence proving this to be true?
Challenging the narrative:
Is excess body weight actually the independent causative risk factor for cardiovascular or metabolic disease? In other words, is excess body fat actually what’s causing high blood pressure, dyslipidemia, or hyperglycemia?
Dr. House makes a great point during the podcast, that if we are going to be discussing cardiovascular or metabolic health, we should be talking about actual markers of cardiovascular and metabolic health; things like blood pressure, blood sugar, or blood lipids. These numbers can be quickly and inexpensively tested and do not have the stigma or moral baggage that comes along with using a person’s weight or size as a judgment of health.
When all of our attention is placed on weight (often BMI) or body fatness, we are assuming that BMI is a proxy for those objective markers of health. But is BMI or even body fat percentage a good proxy for metabolic health?
If a doctor or anyone else has labeled you as either “healthy,” or “unhealthy,” based solely on your weight, BMI, or distribution of body fat, you have received inadequate care.
Depending on the criteria used to define “metabolically healthy,” some studies suggest that 35% of people with obesity are metabolically healthy. This might indicate that simply having obesity isn’t what’s causing metabolic disease, rather obesity and metabolic disease are simply correlated with one another. One of the most basic rules of statistics is that correlation does not imply causation, and there are many risk factors for cardiovascular and metabolic disease which have nothing to do with body weight.
This is great news, because if weight loss does not have to be the primary focus in order to achieve greater health, we’ve just opened ourselves up to a massive array of behavior change options, all of which generally come with far fewer side effects when compared to weight loss. Focusing on healthy behavior change options can be as simple as:
- Increasing your daily step count
- Increasing lean body mass
- Engaging in social activities
- Getting more sleep
- Reducing stress
Compare this to what happens when a weight loss approach goes wrong:
- Decreased quality of life
- Decreased social activity and enjoyment
- Worsened body image
When weighing all of the pros and cons of a weight loss focused approach compared to a weight neutral approach, weight neutral is the clear winner. We’re left with the ability to improve our objective markers of health, a healthier relationship with food as well as our own body and healthier, more high functioning habits overall. Nobody wants or needs to be the person who weighs every gram of food they eat or says no to going out with friends because they don’t know if the menu has low carb options.
I think we’re always best served to stop thinking in terms of weeks or months and focus on years or decades…what does this look like 5 years from now? If I practice these habits over the long haul, what are the outcomes I can expect?
For more information:
Check out the entire podcast here: What the fitness industry gets wrong about the obesity epidemic
Read more from Dr. Gabrielle Fundaro here: https://www.vitaminphdnutrition.com/
Read more from Dr. Ben House here: https://www.deconstructnutrition.com/
