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Diet and nutrition

More exercise for obesity — can the gym really beat the fork?

Sources: 13 · Article: 16 110 characters

The Rodzeń brothers and Prof. David Ludwig point out that exercise alone is usually not enough to lose weight.

  • The Rodzeń brothers add that it is difficult to lose weight in the long term without changing how you eat.
  • Prof. David Ludwig says that most people in the studies did not significantly change their body weight; some lost weight, while others gained it.
  • Exercise can still bring health benefits, and combining it with an appropriate diet can help support a healthy body weight.

What the authors write

Bracia Rodzeń

Physical activity alone is not an effective way to lose weight in the long term without changing how you eat.

„Scientific research is clear: “Physical activity alone is not an effective way to lose weight.” You can run Ironman races and work out 5 times a week, but if you do not change how you eat, you will not lose weight in the long term. Of course, this is no reason not to exercise.”Badania naukowe mówią jasno: “Sama aktywność fizyczna nie jest skuteczną metodą odchudzania”. Możesz biegać Ironmany i ćwiczyć 5x w tygodniu, ale jeżeli nie zmienisz stylu jedzenia, to nie schudniesz długoterminowo. Nie jest to oczywiście powód, żeby nie ćwiczyć.
Bracia Rodzeń
prof. David Ludwig

In a review of studies, most people did not significantly change their body weight after increasing their physical activity, although some lost weight and others gained it.

„Some people lose a few pounds, others gain a few pounds, but most experience no meaningful weight change at all. Why doesn’t exercise produce much weight loss? A simple explanation is that physical activity makes us hungrier, so we “compensate” by eating more.”Some people lose a few pounds, others gain a few pounds, but most experience no meaningful weight change at all. Why doesn’t exercise produce much weight loss? A simple explanation is that physical activity makes us hungrier, so we “compensate” by eating more.
Will Exercise End the Obesity Epidemic?
prof. David Ludwig

Exercise can increase appetite, while greater physical activity may later be offset by less movement.

„A simple explanation is that physical activity makes us hungrier, so we “compensate” by eating more. For instance, a brisk walk before dinner stimulates appetite and enhances the enjoyment of eating. And (unfortunately for dieters) calories enter the body more easily than they leave.”A simple explanation is that physical activity makes us hungrier, so we “compensate” by eating more. For instance, a brisk walk before dinner stimulates appetite and enhances the enjoyment of eating. And (unfortunately for dieters) calories enter the body more easily than they leave.
Will Exercise End the Obesity Epidemic?
prof. David Ludwig

Exercise benefits metabolism, but it is usually not associated with lower body weight.

„Instead, the process of gaining fat may cause people to become less active. None of this is to endorse a sedentary lifestyle. Physical activity has many benefits on metabolism. But short of marathon-level intensity, lower body weight isn’t usually one of them. Exported from Medium on July 6, 2016.”Instead, the process of gaining fat may cause people to become less active. None of this is to endorse a sedentary lifestyle. Physical activity has many benefits on metabolism. But short of marathon-level intensity, lower body weight isn’t usually one of them. Exported from Medium on July 6, 2016.
Will Exercise End the Obesity Epidemic?
prof. David Ludwig

Prof. David Ludwig challenges the “eat less, move more” principle, calling it ineffective and often harmful.

„However, new research shows that “Eat Less, Move More” is ineffective and, in many cases, harmful. Our bodies are too adaptive and complex to be tricked by such simplistic regimes as restricting food and pushing our bodies. This “restrict and burn” concept creates a battle of mind over metabolism that we are destined to lose.”However, new research shows that “Eat Less, Move More” is ineffective and, in many cases, harmful. Our bodies are too adaptive and complex to be tricked by such simplistic regimes as restricting food and pushing our bodies. This “restrict and burn” concept creates a battle of mind over metabolism that we are destined to lose.
"Eat Enough, Move Enough" to Jumpstart Metabolism– Dawn Ludwig
Ewa Dąbrowska

Combining exercise with calorie restriction can lead to weight loss.

„Both calorie restriction and physical exercise increase the sensitivity of cells to insulin, leading to remission of diabetes and hypertension, normalization of lipid profiles, remission of atherosclerosis, weight loss (activation of lipoprotein lipase), and an antithrombotic effect (inhibition of PAI).”Zarówno restrykcje kaloryczne, jak i ćwiczenia fizyczne podnoszą wrażliwość komórek na insulinę, prowadząc do remisji cukrzycy, nadciśnienia, normalizacji lipidogramu, remisji miażdżycy, redukcji nadwagi (aktywacja lipazy lipoproteinowej), a także działania przeciwzakrzepowego (hamowanie PAI).
Leczenie zespołu X metabolicznego dietą warzywno – owocową
prof. David Ludwig

According to Prof. David Ludwig, eating enough while exercising enough should support metabolism and help achieve a healthy body weight.

„Getting enough food while moving enough enhances your metabolism over the long term. The result: you feel good while reaching a healthy weight. Build Lean Muscle Enhance your metabolism by choosing regular exercise that builds lean muscle. *A trick to a metabolically efficient meal is to have the same grams of each macronutrient.”Getting enough food while moving enough enhances your metabolism over the long term. The result: you feel good while reaching a healthy weight. Build Lean Muscle Enhance your metabolism by choosing regular exercise that builds lean muscle. *A trick to a metabolically efficient meal is to have the same grams of each macronutrient.
"Eat Enough, Move Enough" to Jumpstart Metabolism– Dawn Ludwig

Research from PubMed · Europe PMC

We selected 6 studies with the best, positive results. This is a selection, not a full review of all research.

Total number of studies on this topic in PubMed: 18 834.

A meta-analysis found that aerobic exercise in people with overweight or obesity is associated with reductions in body weight and body fat.

Aim of the study: To clarify the dose-response association of aerobic exercise with adiposity measures.

Results: In total, 116 randomized clinical trials involving 6880 participants (4199 [61%] female; mean [SD] age, 46 [13] years) with overweight or obesity were included. Each 30 minutes per week of aerobic exercise was associated with reduced body weight by 0.52 kg (95% CI, -0.61 to -0.44 kg; n = 109 trials, GRADE = moderate), waist circumference by 0.56 cm (95% CI, -0.67 to -0.45 cm; n = 62 trials, GRADE = high), body fat percentage by 0.37% (95% CI, -0.43% to -0.31%; n = 65 trials, GRADE = moderate), as well as the areas of visceral (mean difference, -1.60 cm2 [95% CI, -2.12 to -1.07 cm2]; n = 26 trials, GRADE = high) and subcutaneous (mean difference, -1.37 cm2 [95% CI, -1.82 to -0.92 cm2]; n = 27 trials, GRADE = moderate) adipose tissues.

Aerobic Exercise and Weight Loss in Adults: A Systematic Review and Dose-Response Meta-Analysis. · JAMA Netw Open 2024
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studycombined analysis of many studies (meta-analysis)

“Not stated” does not mean nobody paid — the database does not always record it.

In a 24-week study, people with severe obesity lost an average of 2 kg with moderate-intensity training and 5 kg with a combination of moderate-intensity and interval training.

Aim of the study: This study aimed to compare the effects of two aerobic exercise programs of different intensities on energy expenditure.

Results: A total of 82 (56% females) patients were screened, and 71 (55% females) patients were allocated to HIIT/MICT (n = 37) or MICT (n = 34). Per-protocol analysis showed that EEDE increased by 10% (95% CI: 3%-17%) in the HIIT/MICT group (n = 16) and 7.5% (95% CI: 4%-10%) in the MICT group (n = 24), with no differences between groups. In the 8- to 16- week per-protocol analysis, the HIIT/MICT group had a significantly larger increase in EEDE compared with the MICT group. Resting metabolic rate remained unchanged in both groups. HIIT/MICT and MICT were associated with significant weight loss of 5 kg and 2 kg, respectively. Patients completing a 24-week combined HIIT/MICT program did not achieve a higher EEDE compared with those who completed a 24-week MICT program. The HIIT/MICT group experienced, on average, a 3-kg-larger weight loss than the MICT group.

Effect of Aerobic Exercise Intensity on Energy Expenditure and Weight Loss in Severe Obesity-A Randomized Controlled Trial. · Obesity (Silver Spring) 2021
Money for the studyuniversity or foundation · Vestfold Hospital Trust, University of South‐Eastern Norway
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studystudy with random allocation to groups (RCT)
Participants71

“Not stated” does not mean nobody paid — the database does not always record it.

In women with PCOS, moderate-intensity aerobic exercise lowered BMI, although other types of exercise studied did not lead to weight loss.

Aim of the study: Polycystic ovarian syndrome (PCOS) is one of the most common endocrine illnesses. There is evidence that exercise training positively affects on improvement of the pathogenic factors in women with PCOS. On the other hand, some studies reported similar effects of aerobic and resistance exercises or no effect of exercises on the improvement of the pathogenic factors.

Results: Out of 1140 studies, 19 were eligible for inclusion. The results showed that moderate-intensity aerobic exercise effectively reduces BMI compared to no intervention and Yoga. No other forms of exercise led to weight loss. Additionally, exercise had no impact on sex hormones and regular menstruation. It was concluded that moderate-intensity aerobic exercise is the most effective for reducing BMI in women with PCOS. Due to the limitations regarding the small sample size and lack of subgroup and sensitivity analysis, the results of this study demonstrated that moderate-intensity, aerobic exercise is the most effective exercise for reducing BMI, while the other exercises were ineffective. Moderate-intensity aerobic exercise is suggested to decrease the BMI in women with PCOS.

The effects of different exercises on weight loss and hormonal changes in women with polycystic ovarian syndrome: a network meta-analysis study. · BMC Womens Health 2024
Money for the studynot stated
Do the authors have ties to companies?no — the authors say so
Did a manufacturer help with the study?NO
Type of studycombined analysis of many studies (meta-analysis)

“Not stated” does not mean nobody paid — the database does not always record it.

Combining a Mediterranean diet with calorie restriction, increased physical activity, and behavioral support led to greater weight loss than the control group.

Aim of the study: The long-term impact of intentional weight loss on cardiovascular events remains unknown. We describe 12-month changes in body weight and cardiovascular risk factors in PREvención con DIeta MEDiterránea (PREDIMED)-Plus, a trial designed to evaluate the long-term effectiveness of an intensive weight loss lifestyle intervention on primary cardiovascular prevention.

Results: Diet and physical activity changes were in the expected direction, with significant improvements in IG versus CG. After 12 months, IG participants lost an average of 3.2 kg vs. 0.7 kg in the CG (P < 0.001), a mean difference of -2.5 kg (95% CI -3.1 to -1.9). Weight loss ≥5% occurred in 33.7% of IG participants compared with 11.9% in the CG (P < 0.001). Compared with the CG, cardiovascular risk factors, including waist circumference, fasting glucose, triglycerides, and HDL cholesterol, significantly improved in IG participants (P < 0.002). Reductions in insulin resistance, HbA1c, and circulating levels of leptin, interleukin-18, and MCP-1 were greater in IG than CG participants (P < 0.05). IG participants with prediabetes/diabetes significantly improved glycemic control and insulin sensitivity, along with triglycerides and HDL cholesterol levels compared with their CG counterparts.

Effect of a Lifestyle Intervention Program With Energy-Restricted Mediterranean Diet and Exercise on Weight Loss and Cardiovascular Risk Factors: One-Year Results of the PREDIMED-Plus Trial. · Diabetes Care 2019
Money for the studygovernment, public institutions · European Research Council, Fondo de Investigación para la Salud, ISCIII
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studystudy with random allocation to groups (RCT)
Participants626

“Not stated” does not mean nobody paid — the database does not always record it.

Combining aerobic exercise with dietary advice reduced body weight and body fat and improved fitness and glucose use.

Aim of the study: The sirtuins, SIRT1 and SIRT3, are involved in the control of cellular processes to maintain metabolic homeostasis. The purpose of this study was to determine the effects of a 6-month aerobic training + weight loss program and hyperinsulinemia on SIRT1 and SIRT3 expression in skeletal muscle and to compare their expression between men and women.

Results: This change in basal SIRT1 was not related to changes in VO2max, M or fat mass, nor was it different by gender. Insulin stimulation increased SIRT1 expression (P < 0.001) and PGC1-α expression (P < 0.01) following EX + WL (insulin-basal post). Sex differences in the levels of these sirtuins did not affect changes with EX + WL. Skeletal muscle SIRT1 decreases after a long-term combined exercise and weight loss program in middle-aged and older adults.

Sex differences in muscle SIRT1 and SIRT3 and exercise + weight loss effects on muscle sirtuins. · Exp Biol Med (Maywood) 2023
Money for the studygovernment, public institutions · RRD VA, U.S. Department of Veterans Affairs, NIA NIH HHS
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyother

“Not stated” does not mean nobody paid — the database does not always record it.

A program including exercise and self-regulation training was associated with improved mood and eating control, as well as greater weight loss than a mostly written program.

Aim of the study: Limited knowledge of psychological correlates of weight loss is associated with continuing failures of behavioral obesity treatments beyond the short term. This study aimed to inform health professionals' obesity interventions via an increased knowledge of mediators of the exercise-weight loss maintenance relationship.

Results: Improvements in mood, self-regulating eating, and weight were significantly greater in the in-person group. The relationship between a dichotomous measure of completing at least 3 sessions of exercise per week (or not) and change in weight over 6 months was no longer significant when the mediators of changes in negative mood and self-regulation of eating were sequentially entered. Paths of exercise→negative mood reduction→eating self-regulation increase→weight loss over 6, 12 and 24 months were significant. Exercise self-regulation at Month 3 significantly moderated the mood change→eating self-regulation change relationship. Based on the identified paths, scalable obesity-treatment content and emphases were informed. This could help guide health professionals' actions concerning the management of obesity.

Temporal Aspects of Psychosocial Mediators of the Exercise-Weight Loss Maintenance Relationship Within Scalable Behavior-Change Treatments. · Can J Nurs Res 2024
Money for the studynot stated
Do the authors have ties to companies?not stated
Did a manufacturer help with the study?unknown
Type of studyother

“Not stated” does not mean nobody paid — the database does not always record it.

Perspectives and opinion materials

The content below presents the authors’ opinions, interpretations and hypotheses. It is not treated as equal to scientific studies and systematic reviews.

Orthomolecular Medicine News Service Opinion material
„Both methods will produce weight (fat) loss and, with a little body movement, will shift some insulin receptors from fat cells to muscle. Continually paying attention to diet and exercise and the high level of self-discipline that enables sticking with the program, that should have been required pre-op, will be just as necessary post-op.”Both methods will produce weight (fat) loss and, with a little body movement, will shift some insulin receptors from fat cells to muscle. Continually paying attention to diet and exercise and the high level of self-discipline that enables sticking with the program, that should have been required pre-op, will be just as necessary post-op.
Quick Fixes vs. Real Nutrition Fixes
Orthomolecular Medicine News Service Opinion material
„A five- or ten-pound weight in each hand makes this exercise even better. Nutrients help It has been shown that, with age, one has a diminished ability to make creatinine, a precursor of ATP, responsible for muscle strength. Fortunately there is creatinine in supplement form; so it can be used in conjunction with the "use it or lose it" principle. [2-5] Other supplements of essential nutrients may also help, including the B vitamins, vitamin D, and omega-3 fatty acids. Excellent nutrition including adequate amounts of vitamins and essential nutrients is known to be important for maintaining weight, muscle mass, and cardiovascular health.”A five- or ten-pound weight in each hand makes this exercise even better. Nutrients help It has been shown that, with age, one has a diminished ability to make creatinine, a precursor of ATP, responsible for muscle strength. Fortunately there is creatinine in supplement form; so it can be used in conjunction with the "use it or lose it" principle. [2-5] Other supplements of essential nutrients may also help, including the B vitamins, vitamin D, and omega-3 fatty acids. Excellent nutrition including adequate amounts of vitamins and essential nutrients is known to be important for maintaining weight, muscle mass, and cardiovascular health.
Preventing Falls
Orthomolecular Medicine News Service Opinion material
„Intermittent fasting for weight loss and bone health Intermittent fasting has been shown to have potential benefits for weight loss and metabolic health (Clayton 2023, Tinsley 2015a, Gerboğa 2023). However, its effects on bone health are less clear. Some studies suggest that IF may not have a significant impact on bone metabolism (Clayton 2020), while others indicate that it could potentially compromise bone health, particularly when combined with other dietary restrictions (Clayton 2023, Hisatomi 2019).”Intermittent fasting for weight loss and bone health Intermittent fasting has been shown to have potential benefits for weight loss and metabolic health (Clayton 2023, Tinsley 2015a, Gerboğa 2023). However, its effects on bone health are less clear. Some studies suggest that IF may not have a significant impact on bone metabolism (Clayton 2020), while others indicate that it could potentially compromise bone health, particularly when combined with other dietary restrictions (Clayton 2023, Hisatomi 2019).
A Clinician's Experience of 15 Years of Intermittent Fasting

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