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A New Way of Thinking About Exercise

Poor marketing for exercise has turned many away from more active lifestyles.

Key points

  • Despite mass marketing to the contrary, exercise doesn't work reliably for weight loss.
  • The lack of weight loss benefits has turned many people away from exercise.
  • Although exercise has limited benefits for weight loss, it has powerful benefits for other areas of mental and physical health.
  • To reap the most rewards from exercise, it is important to focus on the proven benefits instead of the marketing.

Exercise might be the most poorly marketed health product in history. For example, one of the famous early exercise role models in the U.S. was Jim Fixx. A former smoker, in the 1980s he converted to a healthy lifestyle consisting of long-distance running, high vegetable intake, and meticulous time management, becoming something of a fitness celebrity in the process. He then died of a heart attack at age 52 while jogging, inspiring couch potato lifestyles everywhere. Even for those whose exercise ambitions were not deflated by Jim’s premature passing, they were misinformed by the multilevel marketing campaign in the U.S. that weight loss is the main reason for exercising. Between relentless advertising pushing exercise programs and products from the weight loss industry and even Surgeon General guidelines endorsing the central role of exercise in weight loss, this message has been almost impossible to avoid.

Why this is such bad marketing is that exercise doesn’t work for weight loss. It never has! In clinical trial after clinical trial—summarized in numerous reviews—weight loss from exercise is known to be modest for the typical person. Historically, the response to these findings from exercise advocates was that people sabotaged their weight loss effects by overeating after workouts or by not maintaining their exercise programs. If only they would control their eating and be more consistent with their exercise regimens said the advocates, they could have lost weight or maintained their weight loss. This blame-the-victim strategy went on for decades (and still does) until research began showing that the modest weight loss from exercise and weight regain patterns resulted from underlying metabolic changes instead of a lack of self-discipline. A long-term New England Journal of Medicine study from 2011, for example, showed that appetite hormones were disrupted for more than a year on average among people losing weight in ways that predisposed them to overeat and regain weight. Similarly, another NEJM study (1995) showed that weight loss triggered large compensatory reductions in energy expenditure that countered long-term weight loss. And the most popular recent example of this research was findings from contestants on the Biggest Loser program. Despite initial weight loss achieved in part through vigorous, supervised exercise, most contestants rapidly regained their weight. Researchers tracking physiological changes in the contestants during and after the program observed reductions in contestant’s metabolic rates well below what would have been expected after weight loss; large decreases in leptin (an appetite hormone associated with fullness (low leptin levels are also associated with anxiety and depression); and a near 50% decrease in thyroid hormones (thyroid hormones help regulate your metabolic rate).

The result of these biological changes? An insatiable appetite, low energy, dysphoric emotions, and the metabolism of a much smaller person (as noted in the 2011 NEJM study, these effects may last for months after significant weight loss). Although few people have competed on the Biggest Loser , millions have experienced their own personal version of this metabolic mayhem. For many people, any calories they consumed during exercise were counteracted by their body’s capacity to lower total energy expenditure. And even for those who successfully lost weight initially from exercise, most are then predisposed to weight regain from the long-term hormone changes. This will be a discouraging picture to some. At the same time, it validates the experiences of countless people who have struggled to lose weight. Recognizing that we’re up against a metabolic system field-tested over hundreds of thousands of years to prevent weight loss may help people cut themselves a little slack!

The combination of exercise physiology and weight loss marketing also has a negative psychological impact. When we are taught that the main reason for exercise is weight loss, and our repeated personal experience are disappointing, the predictable result is a loss of interest in exercise. Many give up or even develop a hatred for exercise. Although abandoning exercise may spare us from more disappointing weight loss results, it also means that we lose out on the numerous proven benefits of exercise. Exercise may not be a reliable weight loss tool for most. However, research makes clear that exercise is an elixir of youth, a drug-free source of energy and focus, a potent remedy for sleep problems, and among the most powerful tools for improving metabolic health (diabetes, fatty liver disease, cardiovascular disease). Exercise may also work as well for reducing depression and anxiety symptoms as psychotropic medicines and psychotherapy for many people. All these life-transforming benefits are established by rigorous science.

If we can tune out the weight loss marketing and focus instead on the ways that exercise can reliably improve the way we feel and function, an active lifestyle can become something we embrace for the rest of our lives. From the brief summaries of scientifically-established benefits of exercise below, see if you can identify one or two that could inspire you to think differently about exercise.

Anti-aging. One of the broadly appealing benefits of exercise is its anti-aging effects. In a twin study, for example, exercise was strongly associated with telomere length (telomeres are one of the most robust markers of biological aging. Longer telomeres indicate that a cell is healthier and capable of replicating itself. Cell death follows when telomeres become too short). The relationship equated to about six years of life for 100 minutes of exercise/week and nine years among twins getting three-plus hours/week.

Energy. At the cellular level, exercise triggers a rejuvenative process called mitochondrial biogenesis. This process refers to the process of forming new, healthy mitochondria. Mitochondria are responsible for energy production in cells. As we age and our health declines, so too does the function of our mitochondria. The subjective result of mitochondrial biogenesis from regular exercise? More energy, vitality, and feeling young again. Have you ever wondered how people who spend hours per week exercising seem to have so much energy? Now you know! Regular exercise has turned them into an energy-producing machine.

Sleep. Exercise won’t knock you out at night like some sleeping pills. However, regular exercise markedly improves sleep quality (7). The better sleep that comes from exercise allows us to feel refreshed and focused during the day. In comparison, prescription sleeping pills have small and often no benefit at all on sleep quality.

Leptin and insulin sensitivity. People with diabetes may know that exercise improves insulin sensitivity. More insulin sensitivity allows the body to produce less insulin and can help reverse diabetes. Most people don’t know, however, that exercise also improves leptin sensitivity. Why is this a good thing? A person more sensitive to leptin feels satisfied on less food, has fewer food cravings, and even enjoys more stable moods. Leptin sensitivity even affects our metabolic rate. When your brain detects sufficient leptin levels, it activates the part of your sympathetic nervous system that promotes movement and physical activity (in the opposite case, leptin resistance triggers energy restriction and feelings of lethargy). Leptin sensitivity is one of our biological secrets to feeling healthy and energized.

Muscle. While muscle is marketed solely for appearance, it is critical to longevity and well-being. Sarcopenia refers to age-related muscle loss. It is epidemic in our aging, sedentary population and is linked to premature death, disability, and low quality of life. Exercise (including aerobic exercise) helps to build and maintain muscle. This remains true at any age. Beyond even these benefits, muscle is a high metabolic tissue that creates energy, enables movement, prevents falls and injuries, and soaks up extra calories through glycogen rather than the body converting the calories to fat.

Liver function. Fatty liver disease is present in 25-33% of adults in the U.S. and is a precursor for diabetes, heart disease, and liver failure. Even though exercise is minimally effective for weight loss, exercise does reduce visceral fat in the liver (8). In our modern epidemic of fatty liver disease, exercise is a crucial tool (there are no medical treatments for fatty liver disease. It is all about exercise, dietary changes, and weight loss). Regular exercise lowers insulin and gives the body an alternative way to burn calories rather than storing them.

Mental health. For years, correlations reported from research between exercise (aerobic and resistance training) and improved mood were criticized as flawed. The counterargument was that happier people are more likely to exercise, instead of exercise increasing happiness. Clinical trials and neuroscience research in recent years have largely debunked this criticism, however. For example, imaging research shows that vigorous exercise increases serotonin synthesis in the brain (increasing brain serotonin availability is how antidepressant medications work).

To become a regular exerciser, it is critical that we think realistically about the benefits of exercise. And for health advocates and health professionals, it is imperative that we begin talking about and promoting exercise based on scientifically-supported benefits instead of industry marketing.

References

1. https://en.wikipedia.org/wiki/Jim_Fixx

2. Thorogood A, Mottillo S, Shimony A, Filion KB, Joseph L, Genest J, Pilote L, Poirier P, Schiffrin EL, Eisenberg MJ. Isolated aerobic exercise and weight loss: a systematic review and meta-analysis of randomized controlled trials. Am J Med. 2011 Aug;124(8):747-55. doi: 10.1016/j.amjmed.2011.02.037. PMID: 21787904.

3. https://www.nejm.org/doi/full/10.1056/nejmoa1105816

4. https://pubmed.ncbi.nlm.nih.gov/7632212/

5. https://pubmed.ncbi.nlm.nih.gov/22535969/

6. Cherkas LF, Hunkin JL, Kato BS, et al. The association between physical activity in leisure time and leukocyte telomere length. Arch Intern Med. 2008;168(2):154-158.

7. Dolezal BA, Neufeld EV, Boland DM, Martin JL, Cooper CB. Interrelationship between Sleep and Exercise: A Systematic Review [published correction appears in Adv Prev Med. 2017;2017:5979510]. Adv Prev Med. 2017;2017:1364387. doi:10.1155/2017/1364387

8. https://bjsm.bmj.com/content/52/13/834

9. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2077351/

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