For Sustained Weight Loss, REALLY Focus on Diet

by Amy Hendel, P.A. Health Writer

Most of us know the standard formula to lose weight — eat less and exercise more. A January 2017 study suggests that the real focus of a successful weight loss plan needs to be diet. The study goes on to suggest evidence that exercise may not be the key to managing weight.

Experts acknowledge the many (verified) health benefits of exercise. These benefits include:

  • Reduced risk of heart disease

  • Reduced risk of diabetes

  • Regulation of blood sugar levels

  • Reduced risk of certain cancers

  • Improved mood

  • Maintenance of muscle mass and bone density

If you go to the Centers for Disease Control and Prevention (CDC) website, you will see “control your weight” at the very top of the list of “benefits of exercise.” Certainly on the HealthCentral website you will also find countless mentions of the link between different forms of exercise and impact on weight and calorie balance.

The researchers in this study point to the assertion that some experts have linked sedentary lifestyle and declining rates of exercise to the risk of developing obesity. It is recognized that a regular exercise habit can also increase appetite levels. People may also overestimate exercise effort and compensate by eating more.

The Loyola study is actually one of the outcome models from Modeling the Epidemiologic Transition Study (METS). METS is a study that involved adults between the ages of 25 and 40, who lived in five countries: the U.S. (Maywood, Illinois), Ghana, South Africa, Jamaica, and Seychelles. Most of the participants were of African descent. These subjects had a broad range of social and economic development. METS started with the assumption that most people, when asked, overestimate their exercise efforts.

The METS researchers used accelerometers as objective tracking devices, and had all of the participants wear the device on their waist for a week. These devices track energy expenditure and number of steps. Height, weight, and body fat measurements were collected on all subjects. At the initial weigh in, the residents of Ghana had the lowest weights (139 lbs. in both genders). U.S. clocked in the highest weights at the initial visit (202 lbs. for women and 209 lbs. for men). The subjects from Ghana were also the fittest, with 76 percent of men and women meeting the U.S. Surgeon General’s Guidelines for Active Living. Only 44 percent of American men and 20 percent of American women were logged in as meeting those guidelines.

Participants then returned for re-evaluation after one year, and again, after two years post initial visit. The researchers found at both milestone visits that the participants, who exercised the most, also gained the most weight. U.S. subjects with the most physical activity gained a half pound each year, while the most sedentary subjects lost 0.6 lbs. The researchers could not find any correlation between “being most sedentary at the initial baseline visit” and subsequent weight gain or weight loss.

If you look at the National Weight Control Registry, which is considered one of the largest long-term investigational models assessing sustained weight maintenance of at least 30 pounds for a minimum of one year, you will find that among the “most common” habits that all the registrants share, is not stopping exercise, even if other health and diet habits are temporarily abandoned. These participants are clear winners in the battle against obesity, so one has to reflect on the fact that among other habits valued as helping them to stay within close proximity to goal weight, an exercise habit was kept in play.

If we do concede that exercise does increase appetite, then the point is to be more vigilant when it comes to tracking calories consumed and calories burned. It may also be important to engage in both aerobic calorie burning exercise sessions and weight training sessions that help to build thermogenic-active muscle mass. Most weight loss experts will still recommend a weight loss program that includes a balanced, calorie-conscious diet that involves measuring portions and an exercise program. Timing of meals and the foods you include in your diet can help to limit hunger — think lean protein at every meal and high fiber grains, fruit, and vegetables. Small amounts of healthy fat also help to keep you fuller, longer.

It is likely that future studies will evaluate the findings of the METS and further clarify the role of exercise in weight loss and weight maintenance.

Amy Hendel, P.A.
Meet Our Writer
Amy Hendel, P.A.

Known as "The HealthGal", Amy Hendel P.A. is a medical and lifestyle reporter, nutrition and fitness expert, health coach and brand ambassador. Trained as a physician assistant, she maintains a health coach private practice in New York and Los Angeles. Author of The Four Habits of Healthy Families, find her on Twitter @Healthgal1103 and on Facebook @TheHealthGal. Check “Daily Health News” at Her personal mantra? “Fix it first with food, fitness, and lifestyle.”