If “sedentary, overweight or obese, postmenopausal women” have pathetic weight loss results with this pathetic routine, why do you think healthy adults should do it when they are capable of more intensive, functional programs??

Found your site via Grand Rounds.

The Cockroach Catcher

Former power-lifter: If you are completely sedentary, steady-state cardio (50% VO2 Max?? ) is better than nothing. If you are serious about losing weight and changing your physique, you need to lift weights. Not 5 lb dumb bells. Weights.

Im 5’8″-9″-ish. In 2 years I went from 130, 25% body fat (at least one hour a day on a treadmill/elliptical/bike), to my peak 160 lbs at 13% bf with power-lifting ONLY. Zero cardio.

I dont have time for power-lifting in grad school, and I have to run the dog (steady state cardio, dirp!), but I make time for heavy lifting, so now I am comfortably at 135, 15% bf.

Unless you are injured or otherwise completely sedentary, Im not surprised at the results of this paper… Well, I am surprised the weight loss was so bad… ‘Max’ of 4.6 lbs lost in 6 months? Shit… Get those ladies to a real gym with a real training program. God that study is almost cruel.

At some point a lot of these things have to be decided on an individual level, as your body generally tell you what is good. Basically you should eat plants, and stay active. If you do that, your brain will release some tasty endorphins and let you know you are on the right track.

Hi Dr. I,

Just a few comments to perhaps lessen your ire, and clarify things.
Not sure if you read my whole post, but I also speculated that a decrease in waist circumference might be good independent of the narrow focus on absolute weight loss, since increased abdominal fat stores are associated with insulin resistance and even some forms of cancer.

Secondly, the American College of Sports Medicine (cool that you’re a member… I can still dunk a tennis ball)…. the ACSM recommending 60-90 minutes of exercise 5 days a week… that’s pretty hard for most people to budget, and probably leads to a lot of people giving up before they’ve begun. Is that 60-90 minute recommendation evidence-based? Can you point me to the relevant Category A/B evidence the ACSM used? I’d really like to read it as a counterpoint to the PLos One study (which probably falls into Cateogry B evidence). Or was this just a “consensus statement” which as I’m sure you know carries less weight, and is very prone to dogmatic repetition of thought leaders’ conjecture (see deteriorating evidence that very tight glycemic control in diabetics improves outcomes, very counterintuitive, but thoroughly disproven, and thought leaders and most physicians are still dogmatically chasing HBA1c levels below 6.5, to the possible detriment of their patients’ health)
http://firstwatch.jwatch.org/cgi/content/full/2009/421/2

I would guess that if you asked the authors of the Plos One study if they had required a cohort of the women in their study to cram in an additional 106-256 minutes of exercise per week, they might speculate that the “compensatory mechanisms” (that rendered all four cohorts’ weight loss statistically insignificant when compared with one another) might also be expected to occur. Unfortunately, they might hypothesize that the extra exercise might not break the trend, and would certainly be unsustainable as a lifestyle, and that a successful weight loss strategy includes many other factors including dietary education as you mentioned, but that was outside the scope of this article and my post on it.

As a clinician, not a researcher, I can tell you that some people are very successful in losing weight, and most do it with diet and exercise. I also see a lot of people who are unhappy, because they are exercising like crazy, trying to eat right, and their weight is not budging. As I mentioned in the very first paragraph and in multiple other places in my post – exercise is wonderful for a lot of reasons. Exercise may not need to be terribly vigorous, but rather the accumulated exertions of an entire day. Did you check out the fidgeting stuff? Interesting. I recommend exercise to just about all my patients without contraindication… but perhaps telling single moms, middle aged professionals with arthritis, and grad students preparing for their oral defenses to find one and half hours, Monday through Friday, for the rest of their lives (?), to dedicate to running on a treadmill as a way to lose weight…. Please show me the concrete evidence, ala this PLos One study, that this is effective and sustainable. The real world lacks your consummate will power!

What and how much we eat seems a better prime determinant of whether we lose weight or not, with exercise being very important for many reasons and certainly not detrimental, unless people are given the wrong expectations. I guess that’s the bigger question… do you think people will stop exercising if more studies like this fail to reinforce current dogma?

I wish I could work out for 2 hours every day, and on some days I do. No one is telling people not to.

Unfortunately for the American Heart Association and College of Sports Medicine, there were no significant differences between groups in terms of amount of weight lost, including the control group that didn’t increase exercise at all …

But, none of the groups exercised in accordance with the AHA or ACSM’s guidelines. The AHA’s recommendation of 60 minutes most days of the week is 300 minutes. The highest activity group here is 194 minutes. So, it’s more unfortunate for the people in the study that they weren’t given a program in line with the current recommendations. They also were not counseled in proprer nutrition. I might be going out on a limb here, but I am going to guess that the people in that study didn’t get obese eating apples and skinless chicken breasts.

The purpose of this study was to determine whether there are compensatory mechanisms that might hinder weight loss with exercise. The conclusion is, yes, there are. So, rather than writing off the benefits of exercise, how do we mitigate the other factors that can sabotage results?