Dr. Sarah Stombaugh:
This is Dr. Sarah Stombaugh and you are listening to the Conquer Your Weight Podcast.

Announcer:
Welcome to the Conquer Your Weight Podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here’s your host, obesity medicine physician, and life coach, Dr. Sarah Stombaugh.

Dr. Sarah Stombaugh:
Today’s episode is inspired by conversations that I have with my patients very often where they’re trying to figure out what is the role that exercise plays in their weight loss. Recently, I had a conversation with one of my patients and she was talking about the amount of exercise that she had done. She walked six miles. She put it into Google and said, “How many calories did I burn during the six mile walk?” And it said about 600 calories based on her body size. And she reached out to me asking, “Is this true?” And the short answer to that question is probably yes. Now, there’s some things that can drive that a little bit up or a little bit down, but one of the things that was really shocking to her is, “Oh my gosh, it’s not actually that many calories burned for the amount of activity that I put in.” And in her mind, she though it was going to be quite a bit more.

Now, this is a conversation that, like I said, I have all of the time because it’s very common that people are either exercising regularly, they’re trying to incorporate in exercise, and it doesn’t move the scale in the way that they expect it to. So if you were in your weight loss journey and you’re trying to figure this out and feeling kind of frustrated, because honestly the math doesn’t always add up in the way that we expect it to, let’s talk today about what is the role of exercise and what is the role of nutrition? Because the reality is the changes that we make from a nutritional standpoint can add up calorically much more significantly compared to what exercise does. Now, one thing I’ve been accused of in the past is that, oh my gosh, Dr. Stombaugh, you say that you do not need to exercise.

I want to be absolutely clear, exercise is phenomenal. If I could take any lifestyle intervention and put it into a pill and say everybody in the world should take this pill, it would be exercise. As I say that, maybe sleep, but sleep and exercise, those two things go hand in hand with one another as some of those most important lifestyle interventions. Exercise has phenomenal roles in terms of improving our overall health. There is nothing that gets our heart beating, our lungs moving, that helps us with balance, that helps us with strengths, that helps us with mobility and day-to-day functionality. Exercise is incredibly effective at improving insulin sensitivity, so that can cause indirect weight loss when we are moving our muscles in that way. People who have conditions like pre-diabetes or certainly type two diabetes, exercising can help with the way that their body is processing that extra blood sugar, helping to reduce insulin resistance, improve insulin sensitivity can be incredibly helpful from a mood standpoint.

A lot of people will notice whether they’re struggling with stress or maybe even anxiety or depression, that exercise is the thing that can really help to lift their mood and help them through those stressful or difficult times. Exercise can be helpful for wearing our body out in a way that we might sleep more soundly, so exercise can be beneficial from that way. We even have phenomenal data saying that exercise is great from a weight maintenance standpoint. So we know that people who’ve lost weight and maintained it for many years, that exercise is one of the most important interventions that they do in order to maintain weight. But what is really frustrating is that exercise is not actually the best tool for weight loss. And let’s talk about why that is. The reality is a lot of times exercise burns fewer calories than we anticipated. So in the example that I mentioned where the patient had walked six miles and the ChatGPT or whatever, Google AI had estimated that she had used about 600 calories in doing that, it is very common that if we put our activity into any sort of activity tracker and we’re trying to estimate the amount of calories that were burned, it can be really disappointing, especially when we’re first doing that and getting used to what it looks like to put those activities into our calculator.

So if we imagine a 30-minute exercise for an individual who weighs 180 pounds, if you weigh more or less than that, these numbers will go up or down accordingly. But for let’s say 30 minutes of exercise for a 180 pound individual, if they are walking for 30 minutes at three miles per hour, so that is a 20-minute mile, a nice pace, but not a very brisk pace, they are going to burn about 120 calories in that 30 minutes. If they picked up their pace a little bit and they went for a brisk walk, so now they’re walking four miles per hour, that’s about a 15-minute mile that they’re walking, that’s going to be 170 calories that they burned. So you might hear those numbers and you’re like, oh my gosh, that’s the size of an apple. That is not a lot of calories that are burned during that amount of exercise.

Even if we’re to jog at five miles an hour or six miles per hour, that is only bumping up calories probably into the range of 300 calories. If we look at an activity like yoga, especially if it’s not a intensive, quickly moving yoga, just your traditional yoga class, a 100 calories will be burned during a 30-minute yoga class, doing cycling on a bicycle, swimming. If you’re going at a moderate pace, so not a leisurely pace, but not an intense pace, just a moderate pace, probably about 250 calories would be burned in 30 minutes. So we think about some of these different movements and it’s like, oh, that’s not a huge. In the range of 100 to 300 calories, we’re not talking about huge numbers of calories that are burned during that period of time. And if you think about the calorie content of food, if you imagine eating a blueberry muffin, that’s probably about 400 calories.

You go to the coffee shop, you get a large coffee drink with some sort of sweetener, like maybe it’s a vanilla or caramel or something like that, latte, you’re probably talking about 400 calories. If you go out to dinner and maybe you’ve just gone for a run, you’ve burned some calories, you’re feeling more hungry, you go out to dinner and you’re like, “You know what? I’ve really earned it. I’m going to have a burger and fries.” You’re probably talking about at least a thousand, if not closer to even 1500 calories, depending on the size and of course how much of it that you eat. Sometimes it’s more sneaky. So we’re cooking dinner, but we’re pretty hungry, so we’re snacking on trail mix because we’re hungry, we burned all that energy during exercise. You can easily eat 300 calories worth of trail mix with just a handful of trail mix as you’re mindlessly cooking dinner, doing your work, whatever it looks like.

So it’s easy to see how those calories that you burned while you’re exercising add up in a pretty measly way. They’re not that significant, and then we can easily outeat that energy. And part of this, it’s not just an I earned it. I know I mentioned that with a burger and fries, and certainly that attitude can come up for people where they’re like, “You know what? I’ve worked really hard, I deserve this, I earn it.” That attitude does come up at times, but a lot of times physiologically our body is more hungry. When we have burned that energy from exercise, our body will respond by asking us for more food. We’ve talked about this in the context of calories in versus calories out. And one of the things that’s really challenging is that that equation is absolutely true and it is so much more complex than just calories in versus calories out.

We have an entire episode dedicated to this that I did last month where we’ve talked about the role of calories in versus calories out. But from an exercise standpoint, one of the things that’s really challenging is that your body has burned that energy and your body is going to ask you then for more energy. Food is calories or it’s measured in calories. Calories are a unit of energy. So when we’re eating, we are consuming energy and that energy can be used for lots of functions in our body, including making up for energy that has been burned through exercise. And so our body responds by feeling even more hungry, which can be really frustrating, especially if you’re at the very beginning of your weight loss journey and you’re trying to navigate what this looks like. A lot of times in my program when I’m working with patients, if they’re already in any sort of exercise regimen, we just leave it alone and have them do exactly what they’re doing at the very beginning of their program.

But if someone is not already exercising, let’s say they’re sedentary because of an injury, maybe because of arthritis, something like that, or they’ve just gotten out of the routine of exercise and it’s not part of their day-to-day routine right now, exercise is not the first thing that I bring into their regimen. A, I don’t want to throw 10 different things at someone because trying to do 10 different things at once often leads to us doing none of those things very well. But what can be really challenging as you’re getting into the weight loss journey that if you bring exercise in as the number one invention or intervention right from the very beginning is that you’re also now dealing with ravenous hunger in a way that you may not be used to, how do I handle it when this comes up in my body? So tends to be something that we’re layering on exercise as part of their journey, but it may be common, especially in this world of GLP medications, that there are patients who are losing weight without exercise and that is okay.

We want exercise ideally to be part of the routine. We want to think about how we can build that in as part of someone’s long-term regimen, but losing weight through nutritional intervention primarily is going to make the biggest dent in that calories in versus calories out, and then exercise becomes just the icing on the cake. So when we get to pair those two things together, it can be absolutely amazing, but that increased hunger that comes from exercise can be really miserable to tolerate at the beginning of your journey. So if you were someone who’s just starting out, don’t feel like you need to add in exercise right now. A lot of times we’re adding it at month three or even as late as month six, especially for people who are dealing with things like arthritis or like chronic pain because of their weight, bringing their weight off first may help them to be more successful as they are exercising.

Now, what is absolutely true, and you hear a lot of this right now, is that exercise can be incredibly helpful at preserving lean muscle mass or preserving muscle mass on our body. Preserving muscle mass during the weight loss journey is one of the most important things that we can do, especially when it comes to preserving our metabolic rate. Our muscle mass is one of the biggest drivers of how much energy does our body use day-to-day regardless of exercise, just at rest, how much energy is your body burning? And if you have more muscle on your body that will help to keep your caloric needs higher, which then also allows you to eat more food, which sounds kind of funny. So exercise can be incredibly good at maintaining that muscle, helping to support you during your weight loss journey. And that’s a big reason why too, eventually as we look at weight maintenance, the calories that we burn from exercise a lot of times are made back up with foods that we eat, but that can be incredibly good from a weight maintenance standpoint because it’s keeping our muscles going, it’s sending that signal to our muscles that, “Hey, you’re important, we need you, we need to burn and use this energy,” which allows your body to maintain its metabolic rate in a way that allows you to maintain calories.

But it is incredibly difficult to out-exercise your nutrition. As we were talking about, the balance just is not in your favor. It would take hours of exercise to balance out some of these meals. But one thing I want to be very clear of, and especially if you’re not used to, you’ve not heard some of my content before and what I preach, is that all foods can fit in our nutrition plan and figuring out, let’s say you love a burger and french fries and you’re like, “Okay, how can I eat this from time to time in a way that’s in line with my goals?” I want you to know that we don’t want to just say, “Okay, don’t ever eat calorically dense foods.” Those foods can be consumed in a very intentional way. So I want you to plan when they’re going to happen. You want to think about what is your hunger and fullness.

You might realize that eating half of the burger adequately fills and satisfies your body in a way that eating the whole burger would not only maybe do, but tip you over past over fullness and that type of thing. So not saying don’t have calorically dense foods, but being mindful that it is hard to out-exercise those calorically dense foods. And so trying to create a deficit in your calories from exercise alone becomes incredibly challenging. As we’re wrapping up this episode, the thing I want you to really think about is what is the role of both of these things? Because it becomes a both and. Nutrition becomes the most important thing we can do, especially from the beginning of our weight loss journey to make sure that we’re emphasizing all of the nutrients that help fuel our body to sustain lasting hunger and to make sure that we’re fueling our body in a way that does naturally create some caloric deficit so that we’re able to support weight loss.

Exercise has incredibly important roles in maintaining our muscle mass, in our mental health, in our cardiovascular and pulmonary health, in our joint health, in our mobility, in our function, and becomes incredibly, incredibly important to layer on as part of your journey. And especially as you look at long-term, what does your maintenance plan look like? Exercise is going to be the key for you, and it’s just part of the picture. If you feel frustrated because you’re like, oh my gosh, there is so much different information on the internet, my goal is to help patients to reconnect with their body, to think about what foods do they enjoy, what foods fuel their body, what exercises do they enjoy, how do they build that in a way that feels sustainable? That is how we support our patients in their weight loss. We see patients in person in Charlottesville, Virginia and by telemedicine throughout the states of Illinois, Tennessee, and Virginia.

If you live in one of those states, I would love to work with you and help support you in your weight loss journey. You can learn more at www.sarahstambaughmd.com. If you are outside one of those states and you’re like, “Man, I wish I had this level of support. I wish I had some structured support as I was starting my GLP medication,” we have a great online program called The GLP Guide. This is the guide that you need if you are starting a GLP medication. You are going to have answers to all your most frequently asked questions, how to use the medication, what to pair with it from a nutritional standpoint, how to exercise when you’re on the medication, how to deal with some of the psychological pieces. When people are commenting about your weight loss, for example, how do you travel with a medication? How do you manage all these different things?

We have answers to the questions that you have with short videos, five to 10 minutes long to help support you in your GLP weight loss journey. You can learn more about that at www.sarahstombaughmd.com/glp. All those links will be in the show notes. Thanks for joining us for this week’s episode. We’ll see you all next time.