Isn’t to some extent, exactly what The Biggest Loser folks do? Restrictive diet in the 1k-1.5K calorie range, and then extremely high volume, low-medium intensity cardio for hours and hours? Essentially burn 2K or so cals in 4-5 hours of various stupid cardio activities and be 2K or so under Sedentary maintenance calories with their diet? Trying to make a 3.5k+ deficit every day?

Now, I’ve written a bit about the Biggest Loser previously when I ran Biggest Loser Feedback; that piece was a segue into a brutally long series on Training the Obese Beginner.  However, I didn’t really address the question that Dan asked above which is why the Biggest Loser contestants certainly don’t seem to have problems losing massive amounts of weight and fat very quickly.  This is relevant as I’ve written previously about Why Big Caloric Deficits and Lots of Activity Can Hurt Fat Loss.  So what’s going on?

Of Initial Body Fat Levels, Leptin, and Metabolic Slowdown

I’ve written previously about the impact of Initial Body Fat and Body Composition Changes; the precis on that article is that fatter individuals tend to lose more fat (and less lean body mass) while leaner individuals tend to lose less fat and more lean body mass.  However, initial body fat levels impact far more than just the proportion of fat and lean body mass lost.  And this, I believe, ties into one issue with the Biggest Loser issue.

As anybody who has read one of my books is aware, the hormone leptin is very much related to body fat levels (caloric intake also plays a role as does the type of body fat but that’s more detail than I want to cover here).  Simply, the more body fat you carry, the higher your leptin levels and vice versa.  So why is this important?

Seemingly irrelevantly, there has been a long-held argument in the research literature regarding the presence or absence of an ‘adaptive component’ to metabolic rate slowdown.  In short, when people lose weight, their metabolic rate goes down.  But sometimes it goes down more than you would predict based on the degree of fat/weight loss.  This increase in metabolic rate drop above and beyond what you’d expect is the adaptive component.

And the argument stems over the fact that while about half of the research studies find an adaptive component during weight loss, the other half does not.   Often this causes people to throw their hands up in despair and just throw science out the window but this isn’t the right approach.  Rather, you have to look at the details.

And when you look at the data set as a whole, and start to group the studies into the ones showing an adaptive component versus those that don’t a pattern starts to emerge: the studies of fatter individuals are the ones that don’t find an adaptive component while the ones in leaner (relatively speaking) folks do.  Basically, once you’re beyond a certain level of fatness, the body doesn’t fight back as hard.

In a related vein, one of the early leptin studies was looking at the impact of leptin levels on hunger during a diet.  They dieted folks and looked at how and whether or not hunger increased.  And what they found is part of the puzzle: so long as leptin was above a certain level (about 20-25 of whatever units leptin is measured in) there was no increase in hunger.  Below that level, hunger started to increase.

And the reason that all of this appears to be happening is that the leptin system in the brain can become saturated; that is, leptin levels above a certain point send no further signal.  And that saturation point seems to be around the 20-25 whatevers level.  And when you track that against body fat level, the level of fatness that equates to that leptin level is something like 20% body fat in men and around 30% in women (my memory may be failing me here, I haven’t looked at number in a while so don’t swear me to these numbers).

Basically so long as folks are above that body fat level, a lot of the metabolic perturbations that can occur in leaner folks just aren’t much of an issue.  I think that’s part 1 of why the Biggest Loser folks get away with a lot of what they get away with: some of the contestants are starting in the 40-50% body fat ranges.  Far far above where the leptin system saturates.

In contrast, most of the folks for whom I hear of problems with lots of activity and big deficits occurring is in leaner (again, relatively) folks.  Exactly the group you’d expect there to be a bigger problem.

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The Sheer Volume of Activity

The second issue I think is playing a role in the Biggest Loser situation is the sheer volume of activity.  As Dan points out, many of the contestants are being put through literally hours of fairly high intensity (at least judging by what’s shown on the show itself) on a daily basis.  Four to five hours per day (who knows, maybe more) is not uncommon.  It’s stupid but not uncommon.

And I think that’s the second piece of this puzzle.  Judging by some of the data, there seems to be a limit to how much the body can adapt to even the largest and most extreme deficits.  For example, in the now classic Minnesota Semi-Starvation Study, the study which found the largest drop in metabolic rate ever measured, the total drop was only about 40% (of which 25% was due to weight loss and the other 15% was the adaptive component).  Certainly this is large.

However, it can still be overwhelmed by a sheer metric ton of activity such that even the metabolic problems caused by the combination of large deficits and high amounts of activity can be overcome.  However, again we’re working at the extremes.  Usually the folks reporting problems with the combination of lots of activity and big deficits are doing a couple of hours of hard exercise per day (or a lot of low intensity stuff).  That’s in addition to starting out leaner.

But that’s far different than the situation in the Biggest Loser contestants where, come hell or high water, they are doing hours and hours of pretty hard training every day without fail.  In this vein, some studies of military folks, often combining sleep deprivation, hours of forced activity, and pretty hard caloric restriction find that body fat levels drop rapidly to the lower limits of survival.  But again this is a situation far removed from the average exerciser doing a couple of hours activity per day.

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The Exception that Proves the Rule?

Although this is somewhat unrelated to the two points above, I think it’s still interesting.  Clearly the Biggest Loser contestants are ‘getting away’ with something that would seem to be, on paper at least, bad.  Or at least in other less extreme populations (leaner folks doing far less activity) that causes problems.  But does that mean that the BL contestants are still doing things optimally?  That is, would a less extreme approach lead to even better results?

In the history of the Biggest Loser show, I can think of at least one or two situations where one of the contestants, usually for medical reasons, was limited to either very small amounts or very low intensity activities.  I’m thinking of one specific situation, might have been Biggest Loser Australia, where an older gentleman was put on medical restrictions.  It was either a cardiac issue or maybe an embolism.

And while everyone else on the show was just getting punished with these hours and hours of high-intensity activity and huge caloric restriction, he was limited to pretty low intensity stuff.  He also had one of the largest weight/fat losses on the show that year.  Might have won it all, I don’t recall.

In other situations, the folks who got sent home early, and who invariably did far less activity and/or used far less extreme deficits came back at the end of the show having far outstripped the contestants who were subjected to the abject stupidity of Bob and Jillian.  Those home-trained folks, the ones combining sane amounts of activity with larger caloric intakes got better results than the folks getting hammered at the extremes.

Does this prove anything?  Of course not.  But there just might be a lesson in there.

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Summing Up

And I think those are the issues worth considering.  In extremely overfat folks doing just massive amounts of activity, not only do you have a situation where the metabolic perturbations aren’t as big of an issue (at least not until a certain degree of body fat loss has occurred) but you also have a situation where the sheer amount of activity can overcome any metabolic slowdown that does occur.

Contrast that to folks starting out leaner who aren’t doing 4-5 hours of hard exercise per day but rather 1-2 and trying to combine that with a big deficit.  Not only are their bodies more likely to undergo metabolic adaptation, the volume of activity just isn’t there to overcome it.  So things grind to a crawl.

Finally is the issue that even on the Biggest Loser itself, some of the more amazing transformation came from contestants who, for whatever reason (medical or being booted off the show and training at home) got better results than the folks still on the show who were being slammed with extreme amounts of activity and big caloric deficits.

Thanks for the comment Dan, you saved me having to think a feature article topic today.

By raising her calories gradually, her body fat (as measured by BIA) came down and her metabolic rate increased.  Now, without more details, it’s hard to really comment on this and the link to the case study is the total amount of information available.

But we’ve got an older (either post-menopausal or peri-menopausal) woman, undisclosed anti-depressant medication, self-reported food intake and a method of body fat measurement that is, at best, problematic (read Methods of Body Composition Measurement Part 2 for more details).  Odd things happen metabolically around menopause, some medications can cause issues, food reporting is notoriously inaccurate and BIA isn’t ideal to track changes.  Then again, the measured metabolic rate change is pretty interesting; something was going on.

That said, I’ve mentioned in previous articles that one oddity that I’ve seen (and personally experienced) over the years is one where the combination of very large caloric deficits and very large amounts of activity (especially higher-intensity activity) can cause problems for people either stalling or slowing fat loss.

Like my previous article on The LTDFLE, or Long-term Delayed Fat Loss Effect, this is one of those oddities that seems to crop up more often than you’d expect.  It’s also one where there’s not a ton of research but I will happily provide a good bit of speculation on what I think may be going on.

I’d also note that the combination of big caloric deficits and large amounts of activity clearly isn’t detrimental to everyone.  Some folks can get away with it but, for many, it tends to backfire more than anything else.

First, Some Background

Back in my early 20′s, I remember a very specific client I had.  She was a little bit, well, to be honest nuts.  She was older, I think she had gone through menopause but I wouldn’t swear to that.  In any case, she started working with me, determined to lose weight and immediately jumped into something like 2 hours of cardio per day and cut calories massively.  She claimed 600 calories per day and I won’t even try to describe her diet; it was insane (breakfast was supposedly one-half an egg and to this day I’m not entirely sure how you eat half an egg).

Now, I didn’t know much at that point but I had this general idea that too much activity and too few calories was a bad thing.  For weeks on end I entreated her to either cut her activity or raise her calories.  She adamantly refused; how could that possibly work?  I tried to point out that what she was doing wasn’t working either and she could hardly do worse by trying something different but that line of logic went nowhere.

In any event, at one point she went on a cruise or a vacation or something.  And what do you think she did?  Exercised less and ate more like everybody does on vacation.  And she came back something like 5 pounds lighter (some of which may very well have been The LTDFLE mind you).  “See, see.” I told her, “You ate more and exercised less and good things happened.”

And she immediately went back to a massive caloric deficit and over-exercising.  But that’s how it goes sometimes.

Later in my 20′s, mind you, I’d do the same thing during the now infamous Bodyopus experience (probably the singular experience that taught me what NOT to do during a fat loss diet).  Frustrated by stalled fat loss (I had dieted far too long at that point in the first place), I worked even harder, cutting calories further and adding more activity.  That coupled with some genuinely awful ‘carb-loads’ took fat loss to a standstill.

In addition to those case studies, this is a phenomenon that I’ve seen elsewhere including the support forum, I imagine readers run into it constantly: people (frequently but not always women) who try to combine excessive caloric deficits with massive amounts of activity (often with a lot of that activity being high-intensity activity) and nothing is happening.  And if you can get them to reduce activity (or just cut back the intensity to reasonable level) or increase calories, things invariably start to work better.

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What’s Going On: Let’s Talk About Cortisol

Cortisol is one of those hormones that I imagine everyone reading this has heard about and about which a lot of misinformation exists.  Simply cortisol is a stress hormone, released by the body in response to nearly all kinds of stress.  In the fitness/bodybuilding world, cortisol has gotten an almost exclusively negative reputation (cortisol is ‘bad’ in the way that testosterone and thyroid are ‘good’) although this is simplistically incorrect.

Rather, whether cortisol does good things or bad things in the body depends on how it’s released.  Simply (and I’d simply, ha ha, refer folks to Robert Sapolsky’s amazing book Why Zebras Don’t Get Ulcers for a detailed look at this; I also talk about cortisol in The Stubborn Fat Solution), acute pulses of cortisol tend to do good things and be adaptive and chronic elevations in cortisol tend to be bad and be maladaptive.

For example, the morning cortisol pulse helps to promote fat mobilization.  In contrast, a chronic elevation of cortisol (especially in the face of high insulin levels) tend to promote visceral fat accumulation.  As a non-fitness related topic, acute pulses of cortisol tend to be good for memory (why we often remember stressful situations in such detail) while chronic elevations (as often seen in depression) make memory go down the toilet.  And there are endless other examples of where acute cortisol pulses are good and chronic elevations are bad; again see Sapolsky’s book for details.

In any case, dieting in general is a stress.  And of course training is a stress.  And the more extreme you do of each, the more of a stress occurs.  And I suspect that a lot of what is going on when folks try to combine excessive caloric deficits with massive amounts of activity is that cortisol just goes through the roof (there’s another issue I’ll come back to at the end that relates to this).  Simply, you get these massive chronic elevations in cortisol levels.

Tangentially, this is also one reason I suspect that various types of cyclical dieting help with some of this issue.  For at least brief periods, when calories are raised to maintenance or above, you break the diet/training induced elevations in cortisol.  This of course assumes that the person isn’t mentally stressed to the nines by raising calories like that but I’m getting ahead of myself.

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So Why is This Bad?

As noted above, chronic elevations in cortisol can cause a lot of bad things to happen. One of them is simply water retention and I’ve mentioned in previous articles that water retention can mask fat loss, sometimes for extremely extended periods.  I talked about this in some detail in The LTDFLE and suspect that some of the ‘fat loss’ is actually just water loss when calories are raised and cortisol mediated water retention dissipates.  Reducing total training (volume, frequency, intensity or some combination) does the same thing.

But that’s probably not all of what’s going on.  Another effect of chronically elevated cortisol levels is leptin resistance in the brain.  I’m not going to talk about leptin endlessly here again, you can read the Bodyweight Regulation Series for more information.  When the normal leptin signal to the brain is blocked, a lot of things can go wrong metabolically and I suspect that this is part of the problem.

In this vein, although not necessarily related to cortisol per se, at least one study found that the addition of 6 hours per week of aerobic activity to a very low calorie diet (in this case a protein sparing modified fast) caused a larger decrement in metabolic rate than the diet alone.  The body appears to monitor caloric availability (simplistically caloric intake minus output) and if it gets too low, bad things can happen.

This is why I so strongly suggested AGAINST the inclusion of much cardio in The Rapid Fat Loss Handbook; it causes more harm than good.  Invariably, the biggest source of failure on that plan is when people ignore my advice and try to do a bunch of cardio.  And fat loss stops.

In any case, there are several different plausible mechanisms by which the combination of excessive caloric deficits an large amounts of activity can cause problems.  Whether it’s simply cortisol related water retention, a drop in metabolic rate due to leptin resistance or something else, something is going on.  From a more practical standpoint, for a lot of people, the combination simply doesn’t work.  Mind you, some seem to get away with it but not all.

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An Additional Variable

There is another variable that I have noticed over the years in looking at this issue.  As odd as it sounds, it has to do with personality.  In discussing this, for example, I’ve often noted that the people who seem to have the biggest issues with the whole lots of cardio/big caloric deficit tend to be a little bit ‘tightly wound’ (to put it politely).  A bit less politely they are stress cases.

You can almost ‘hear’ the stress in their typing.  Every post has lots of exclamation points and there is this undercurrent of “I MUST LOSE FAT NOW!!!!!!”  in their posts. When fat loss stalls for a day, they freak out and want to cut calories or go add another hour of cardio.  You can almost ‘see’ the tension in them as they sit hammering at the keyboard looking for solutions.

And this is an issue because these types of folks already over-secrete cortisol.  As a true oddity, there is the issue of amenorrhea (loss of menstrual cycle).  Typically it’s been thought to be related to body fat levels or caloric intake and this is a general cause.  But there is often a type of amenorrhea seen in women without any of the normal predisposing factors.  In this case, it’s all due to mental stress.

Basically, there is a subset of folks who are already high-level stress cases. They tend to be drawn to harder is better in the first place, tend to be resistant to change (like my client from my early 20′s) and their already high level of cortisol production is simply amplified by the combination of too much activity and too few calories.  And suggestions to raise calories and/or reduce activity are invariably met by resistance (again, like my client from ages ago).  What they really need is to just chill the hell out.

But invariably the approach that they are intuitively drawn to is the wrong one for them: moderate deficits and moderate activity always work better in those folks.  It’s getting them to do it that’s the hard part.

Tangentially, I suspect that the classic hardgainer is of a typical type but that’s another topic for another day.

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Summing Up

So that’s that, a look at one of the oddities of fat loss, the situation where the combination of excessive caloric deficits and excessive amounts of activity seem to hurt rather than help fat loss, along with some gross speculation (and just enough research to make it sound like I know what I’m talking about) on what may be going on.

In a practical sense, of course, most of the background isn’t that relevant.  The simple facts for the majority of folks is this: you can either cut calories hard OR do large amounts of activity.  But you can’t do both.  Well you can do both, you just probably shouldn’t under most circumstances.

Today I want to look specifically at how I approached training (again noting that there are obviously more ways to approach the situation than just this one).  I’ll also look a bit at some things I might do differently now as well as talking about progressions, variation, etc. to keep the obese beginner moving towards their goals.  And I will finish today even if it ends up being long.

We catch up with a beginning trainee just having done roughly 30 minutes of paperwork and possibly some basic measurements (tape measure, weight, skinfolds, depending on the situation) leaving roughly 30 minutes or thereabouts for the first workout.  What did I have them do?

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Part 1: Cardio

Pretty much without exception, we’d start with cardio.  Usually I’d use the treadmill and I choose this for a variety of reasons.  First and foremost, everybody knows how to walk.  Second, the intensity can be easily controlled by adjusting pace and incline.  Third, walking tends not to cause the local muscular fatigue that something like an exercise bike or Stairmaster or whatever does in beginners since it’s more whole body; this limits unpleasant sensations and excessive fatigue that tie into the aspects of generating positive affect I talked about in Training the Obese Beginner: Part 4.  Fourth, it gave me a chance to chat and give the first of many mini-lectures without having to worry about any other issues.

I would note that there is no real reason not to go outside and walk if that’s available.  It is harder to gauge the intensity but can have benefits in terms of teaching clients that they can always find something to do activity wise even if they don’t have machines available.  But I was always working in environments where the outdoors were busy streets or the gym was in a strip mall or what have you and I had to work with what was available.

At one gym I worked at, we didn’t have treadmills so I’d walk with them on the track that surrounded the main area.   In contrast, two friends in the Austin area get their clients walking outdoors since the area around the gym will support it and they don’t want them reliant on machines.  It’s just a function of adapting to what you have available and trainers need to keep in mind that the principles are what’s important; the details less so.

Now, I said previously that I generally see it as a ‘waste’ to monitor cardio with clients.  This is true although sometimes you have to or it doesn’t get done.  If a client wants to pay me to keep them company on the treadmill, I guess that’s their problem even if I’d rather them get into the habit of doing it on their own so the hour is spent on more useful things.

However, in the initial stages, since they don’t need much weight training and I had the time, I would monitor their cardio sessions.  This allowed me to give a lot of little mini-lectures which goes towards the education aspect of training I mentioned in previous parts of this series.  Cardio sessions were an excellent time to start educating the client about what they were doing and why they were doing it.

It’s all too easy as a trainer to just say ‘Do this’ but that may not help the client ideally in the long term.  What if they move, what if you move, what happens when you go on a vacation? A lot of things can happen that cut the client off from you.  If you’ve taught the client why they are doing certain things and how to train, they can do it on their own.

If you’ve made them nothing but reliant on you, you haven’t done that.  My goal, in a lot of ways, was to get my clients to the point that they didn’t need me any more.  Perhaps not fantastic from an income perspective but it was the only way I felt good about what I was doing.  I usually found that, if I were doing my job well, clients would often continue hiring me because they wanted to do so, not necessarily because they needed to do so.

In any case, a key mini-lecture that I always gave on the first day was to explain the FITT principle of training: frequency, intensity, time and type.  Or how often, how hard, how long and what.  I needed to make them aware of things like minimums for activity (e.g. 3X/week for cardio work, more if possible but 3Xweek as a minimum, weight training a minimum of 2X/week).  Time (e.g. 20 minutes cardio as a minimum, more may be better, but that’s the minimum).  Type of cardio activity, really doesn’t matter at this point, do what you’ll consistently do.

But the big one for this first lecture was intensity.  How hard does it need to be to be worthwhile and how hard did I want them working.  This ties into the stuff I talked about in Training the Obese Beginner Part 4; since most were at least familiar with the concept, I’d first introduce them to the whole idea of heart rate and then basically throw it out, preferring to use the rating of perceived exertion (RPE) scale.  It’s less of a hassle than using heart rate and, with practice, turns out to be just as accurate.

I used the 1-10 RPE scale (rather than the original 6-20, explaining the distinction will have to wait for another article) and would give them an idea of the ranges by describing 1 as sitting on the couch and 10 as an all-out effort (I used the example of getting to the airport late and having to sprint to the terminal and feeling like you’re going to die in the process since that was something most could relate to).

I told them that, during their initial cardio sessions, I wanted them working at about a 3-4 on this scale, which I described as challenging but doable (so not too hard but not too easy either).   Which is sort of interesting since it basically would seem to be what the data on affect and self-paced activity suggests; let people work at a self-selected intensity and they’ll work at a challenging but achievable level somewhat below the point where they would cross the ventilatory threshold and start to generate a negative affect.

And, without even knowing that what I was doing might be a good thing, I let them set that intensity to start with.  Usually it was fairly slow, brisk walking if that.  I didn’t care.  I told them to make it challenging but not impossible and usually they’d pick the right pace or maybe a little bit below that.

If I had them check heart rate, it was always pretty much in the right spot anyhow or maybe a little bit below the supposed ‘ideal’ range.  And, as I’ve hammered throughout this series, I far more interested in them accomplishing the workout successfully than how hard they were working; there would always be time to increase the workload.

Related to this, someone in the comments section of Training the Obese Beginner Part 4 asked about the ‘talk test’ and this is another valid way of setting a proper aerobic intensity.  I would tell my clients that another way to gauge cardio intensity is that they should be able to keep a broken conversation during the workout.

That if they could talk non-stop it was too easy, if they were gasping for breath between words, it was too hard.  If they could keep a broken conversation, that was right.  This would invariably put them at the same 3-4 RPE and correct workload/HR for them.

Now, as I noted in a previous part, I have had beginner clients for whom 5 minutes of continuous activity at even this moderate of a workload was nearly at their limits.   I would simply tell them to stop the session if they started to feel particularly fatigued and let the duration fall where it may in that first session.  If it was 5 minutes, that was fine.  if they went to 10 minutes, I’d usually still stop them since we had other stuff to do with the remaining time.

But now wasn’t the time to push things at all.  Remember the goal: break them in without breaking them.

If there were time later in the session, I might take them back to the treadmill for 5-10 more minutes.  An alternate approach would be to throw in 5 minutes of cardio in-between weight exercises if the time is available.  Do 5 minutes 4 times and you get 20 minutes across the session; do 10 minutes twice and you get the same 20 minutes total and a successful initial workout.

Either way, the client gets 10-20 minutes of activity, without dying in the process in their initial workout which was just fine with me.  Even if they only get 10 total minutes, that’s still more than they would have done otherwise and I’d always get them to add a minute or two at the next workout to start working on progression from the get go.  It usually only took a few workouts (or maybe a couple of weeks tops) to get them to 20 minutes of continuous activity.

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Part 2: Weights

After cardio was done, it was time for weights.  Those of you embroiled in the current trends in fitness are wondering ‘what about the dynamic stretching, what about foam rolling, what about activation?’  Well, I didn’t do any of it.  At the time, nobody did and I wouldn’t have had time anyhow during the first session.  Full range weight training acts as a dynamic stretching stimulus as it is.

Make no mistake, that’s all fantastic stuff to add if you have time and they have the interest (and certainly it can be important and play a role in the gym).  But this is about day 1, the goal was getting them through 20-30 minutes of activity successfully.  Even if I had known about all that currently trendy stuff, I wouldn’t have done any of it.  Not on day 1 anyhow (I’d often stretch clients at the end of workouts at later sessions).  Save it for the second or third session when you have the full hour and more time to work with.

So now we went to weights.  And here I will show my hereticism and spur yet another silly debate in the comments section: I used machines almost exclusively and almost without exception (sometimes I’d teach a dumbbell chest press if I were bored with teaching the chest press machines).  Yes, I know…non-functional.  Yes, I know…body weight is better.

But guess what?  It really doesn’t matter at this stage and remember my overarching goal: generate success without breaking the client.  And in untrained beginners with no previous training background or movement background, anything more complex than the simplest of stuff is too much under most circumstances.  I saw too much to lose and little to be gained by using more complexity than a basic machine approach provided.

Now, people with a movement background can’t understand this, they understand where there bodies are in space, they don’t understand why someone new to activity (whether obese or not) just feels like a moronic spazz trying to do complicated stuff.

If you give an obese beginner that type of stuff (whether functional movements or simply complex free weight exercises) and they tend to feel terrible; they can’t do it, they feel uncomfortable and that is a bad thing on the first day.  I didn’t see it as generating the positive reinforcement I wanted and could always teach those movements later as necessary.  This was sort of the vague point I made in an earlier part: with total beginners you have to get them in shape to train.  That means using activities that they can actually accomplish meaningfully.  Many movements in vogue today don’t meet that important criterion in my opinion.

As well, I often only had 3 short sessions to get the person to basic competency in the weight room; as I discussed in detail in the Beginning Weight Training series, that tended to limit how complex of a movement I could teach.  I could get them to basic competency on machines in 3 sessions.  No way could I teach anything much more complex like a squat or what have you.  Because they’d end up killing themselves training alone on those movements; they’d know just enough to get hurt.

Now, once again, I realize that the above is heretical in the day and age where ‘functional’ training and body weight stuff are all the rage.  So…

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Let me Rant A Little Bit About Body Weight/Functional Exercises

I read a lot of training e-books, it’s part of my job to keep track with what people in the industry are doing and where the trends are moving so that I can bitch about it.  And I always smile when I see someone advocating things like t-pushups and burpees and all of that trendy bodyweight stuff….and the exercises are almost always being demonstrated by someone who weighs maybe 160 lbs and is already fit.   And who has spent most of their week reading marketing manuals and working on their sales page.

Because if you think an untrained female who weighs 300 lbs can do a push-up period much less a one-armed t-push up then you’re out of your mind.  Burpees are often just as bad; they can be done but not well.  Those types of movements end up being a miserable disappointing experience for the beginner obese client in my opinion.  And since I don’t see them as accomplishing much more in this population than simpler, more easily learned, movements, I see no point to them.  At least not initially.  Please note that last word before you leave nasty comments on this article.

Similarly, it used to kill me watching a 130 lb female personal trainer putting their 250 lb female client through walking lunge sets.  I mean, that’s what the trainer (who is light with years of training behind them) does to look all hot, what’s the problem?   But that trainer has no clue about what’s it’s like to be that big, to have no movement background or years of training.  Nor do they seem to see the problems the client is having with the movement (knees breaking in, torso collapsing); they are usually too busy flirting with the cute guy in the tank top or another personal trainer.

Again, I know that there is this popular meme that you need to be able to control body weight before you lift weights.  And that’s true maybe if you’re working with young male athletes who can actually do body weight movements well from the get go.

But it’s rarely true if you’re working with untrained older individuals who haven’t done an ounce of exercise for a decade.  And almost never true for the obese beginner who I’m writing about.   Maybe for some lower body movements but certainly not upper body where neither the strength nor coordination is there.

Basically, for a lot of body weight movements, you need a base of strength to be able to do them competently.  And if you can’t do them competently (or at all) because the load of your body is simply too high, then you can’t use them to gain the strength that you need.

In contrast, by using machines, I could start with weights that were far lighter than body weight to actually build the basic strength and technique needed to do more complex stuff down the road.  And do so in a controlled environment and in a fashion that let me provide positive reinforcement by having the client experience success from the first workout on.  Which, as I continue to hammer home I feel is a key in training the obese beginner (and arguably less true in training the psycho motivated wannabe athlete in which case, go to town).

Related to this, I’ve noted that many beginners are already self-conscious as hell about being in the gym in the first place, and this can be even more true for the obese beginner.  Making them look (and more importantly feel) foolish in the gym by giving them complex movements that they can’t do is not good for adherence.  They have to feel success and they have to feel it from day 1.

In a related vein, I tried to avoid having my obese clients have to get up and down off the floor too often; as that seemed to also cause embarrassment for some.  For that reason alone, even though I think poorly of most of them, I usually used ab machines rather than floor ab work.  I simply taught them correctly (focus on spinal flexion rather than hip flexion).

Which isn’t to say that I don’t think that more complex movements are useless in this population; there may very well be specific situations where they are appropriate.  They could always be added later after the client was into good habits, had lost some weight, had developed some of the basic strength and fitness needed to do them and needed some variety in their training or to move to something more intensive.

But I don’t think they are the right thing to start with under most circumstances.  That is, I’m not saying that I used machines exclusively forever (I know at least one person will claim that in the comments section), simply that I usually always started with them.

Ok, let’s get off that soapbox…I’ll save the rest of that rant for a series on exercise choice that I’m going to write at some point.

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Back to my Point

So I used machines with the majority of beginners, obese or not.  Because my goal was to get people in shape to train, to get them into regular exercise habits and to do it in such a fashion that they got the greatest chance of feeling success from the first to second workout.  And complex multi-planar and/or body weight movements don’t tend to achieve that goal in my opinion.  There’s too much going on and too much chance of embarrassment or feeling bad about it.

On machines, I could control not only the loading more accurately but ensure that they got at least something out of it training wise since they could actually do more than a handful of repetitions without dying in the process.   So that’s what I did and this is how I approached in in that first session.

Following cardio of whatever duration, we’d go do weights, typically 4 movements on the first day (the routine I traditionally used appears below).  That allowed me to train the ‘full body’ and was about all I had time for at this point anyhow.  Again, it allowed me to break them in without breaking them.

Now I come from the ‘tell me, show me, involve me’ school of teaching.  First I’d introduce the exercise and tell them what it was and what it trained.  For example, “This is the chest press, it will train your chest muscles along with your shoulders and triceps.  If you had to pick only one or two upper body exercises, this should be one of them along with the next movement I’m going to show you which is the row.”

Then I’d show them how to do the movement focusing on just a handful of technique cues explaining as I showed a few repetitions.  What the movement pattern was, rough movement speeds, along with how to set the machine and how I’d note the settings on their workout card so they got used to the notations on weight, sets and reps along with how to set the machine on their own.  I’d also introduce them to breathing although, as noted in Breathing During Weight Training, I didn’t get into many details on the first workout: I cared that they breathed, not how they breathed.  Those could wait until workout 2 or 3.

Then I’d have them do a set.  I always went light, most of this was experience in terms of where to start and I always erred on the side of too light.  I know that there are charts with percentage of body weight to start movements at; I never used them and don’t recommend that you do.

It never hurts to start too light and can hurt a lot to start too heavy.  Remember the goal of the first day: break them in without breaking them.  I didn’t want them to be sore the next day if I could avoid it (invariably pecs always got a bit sore no matter how light I went, I have no idea why).

As well, this allowed me to apply one of the ‘tricks’ I mentioned in a previous part of the series.  By starting super light on day 1, I was usually able to have them increase the weight a little bit at the second workout.  That was along with them feeling much more comfortable in the movement patterns and more confident.  I could tell them that they had already made progress.  More importantly it was progress that they could usually feel in terms of the movement patterns feeling more comfortable.  Seeing the weight go up from workout 1 to workout 2 didn’t hurt either.

Was it real progress in terms of strength?  No, not really.  But yes, sort of in that there is a neural component of learning to lift.  But mostly it was a function of my starting so damn light that they couldn’t help but raise the weight.   It may be a trick but the end result was the same; they could see that their efforts from day 1 weren’t ‘wasted’, immediate progress was part of positive reinforcement.  Even if I had to cheat a bit to get it, I wanted them to feel not only success on Day 1 but progress by Day 2.

During that single set, I’d cue every repetition, depending on the movement and the gender I’d use touch training to get them aware of the muscles involved (e.g. placing my hands on their mid-back and cueing scapular retraction during rowing, often actively moving their shoulders forwards and back to show them the movement they should be doing).  Be careful with this: ask before you touch and don’t touch inappropriately (e.g. a male trainer cueing a female trainee’s pecs is looking for a lawsuit).

For some movements, I might lead them through the first few repetitions to show them the movement pattern.  So if I were teaching a DB bench press, I’d manually follow them through a few reps moving them through the curved movement before letting them go on their own for the remainder of the set.

They also got a second mini-lecture during this part of the workout: I’d tell them that the goal was anywhere between 8 and 12 repetitions and to stop if they felt it getting too challenging.  Usually, by selecting the right weight, they always got to 12 the first day.  Not every time but almost always.

I also taught them the basics of a single progression approach; basically I told them to get as many reps as they could get in good form and when they got to 12, that they should go up in weight a little bit (this often meant showing them how to use little plates to increment the weights in smaller jumps than most machines will allow).  I’d tell them that a weight increase would often drop the reps back to 8 (or sometimes less) and to build back up to 12 and then go up again.  Is this an ideal form of progression?  For beginners, I think so.

Now, here’s the exact ‘basic’ workout I used with beginners of all sorts. Sure I gave them the ‘you’ll get an individualized program’ speech but, let’s face it, this is mostly nonsense.  Beginners all need basically the same thing unless you’re dealing with injuries or whatever.

1. Leg Press (1)*
2. Calf Raise (3) (done on leg press machine after leg press)
3. Leg curl (2)
4. Bench Press (1)*
5. Row (1)*
6. Shoulder Press (2)
7. Lat Pulldown (2)
8. Triceps Pushdown (3)
9. Biceps Curl (3)
10. Crunch (1)*
11. Back Extension (3)

The numbers after each exercise indicate the workout number I introduced them at.  So everything with a 1 (leg press, chest press, row, crunch) was done at the first workout.  At the second workout, those 4 would be done with the addition of everything with a 2 after it: so the leg curl, shoulder press and lat pulldown.  At workout 3, I’d add the direct arm work and back extensions.

The exercises with a * after them are sort of the ‘big 4′ I would emphasize.  I’d make the clients aware that, if they had massively limited time (e.g. only 10 minutes to train), just doing those 4 movements would basically work ‘everything’.  I’ll come back to this point below.  You might note that the exercises are ordered to move from larger to smaller and to alternate pushing and pulling movements to minimize fatigue.

So within 3 workouts, I would move them from 4 movements to a total of 11.  Again, doing 1 set of 8-12 reps/exercise and progressing weights as they were able (E.g. get to 12 reps easily, time to move up).  By the time you factored in teaching and re-cueing things, along with an increase in cardio duration before and/or after, this usually made for a full hour of training.

So within 3 workouts, having started at a very moderate 25-30 minutes or less, I’d have them to a full hour of a basic routine and do it without really overwhelming them too heavily.  The weight routine itself rarely took more than 30 total minutes to complete; as I noted I often moved clients to 30 minutes workouts so long as they were willing to do cardio on their own time.

Some of you may question the inclusion of such small muscle group movements as arm work or whatever.  To a degree this was a bit of pandering to the client.  Men always want arm work to get buffed and women are concerned with ‘toning their arms’.  So I put it in to keep them happy.  Sure, we can quibble but there is an element of keeping the client happy.  It never took more than a few minutes anyhow.

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Cardio Progressions and Variations

So that was the first 3 basic workouts, moving them to what I considered a full hour workout fairly rapidly.   Often they would go off on their own at that point and I had to hope that I’d given them enough information to progress on their own without me.  That was part of the endless mini-lecturing during every workout (many would often hire me again 6 weeks later for a new routine).

But assuming I continued working with them, the focus from that point on was then on progression from that basic workout.   With the cardio, the goal was to first get them to a minimum of 20 minutes continuously at least three times per week, regardless of the pace.  This is sort of the bare minimum to start building any type of aerobic fitness and get any sort of metabolic or physiological effects and I could get most there with some type of work within a few workouts.  Of course, I always encouraged folks to do more on their own time if they were able or willing.

But the first goalpost was to hit 20 minutes three times per week consistently.  More was better but that was the bare minimum I wanted to see.  In some cases, I’d be overseeing the cardio; in others I was only handling weight room stuff and cardio was being done on the client’s own time (either before or after weight training).

Around week 4, clients usually saw the first cardio adaptation where they would invariably report some experience out in the real world where their increased fitness came in handy; even if the initial fat loss was slow in coming this invariably had the benefit of making them realize the benefits of what thye were doing (invariably by week 8, measurable fat loss would have occurred).

One specific case comes to mind, a client who had gone camping with her family and was able, for the first time, to carry her child on her back without gasping for breath.  This was huge for her and acted as a massive positive reinforcement for the role of exercise in her life; she was able to do something important to her with less effort.  But as noted, this is usually a slower adaptation for cardio stuff which is why it was so important in my mind to focus on weight room stuff and clients feeling progression and positive feedback there.

Around week 4, assuming the client had been getting their consistent cardio in, I’d also usually start introducing them to working a bit harder during the cardio sessions.  While it wasn’t formal interval type training, I’d get them to start introducing 30-60 seconds of exercise at an intensity that was above their current comfort zone within their cardio session.

It was a way to start getting them used to working a bit harder as well as pushing their fitness up to the next level.  It also helped to make them aware, or so I hoped, that they couldn’t expect to stay at the same level of training forever and keep seeing progress; at some point they had to push a bit harder and get out of their comfort zone. But I always made sure that they had reached the first goalpost and gotten into good habits with more accomplishable stuff first.

So if they were doing 30 minutes at a moderate pace at this point, I’d have them go 1 minute harder every 5 minutes and push just a little bit above their current comfort level (I’m talking maybe a small bump in treadmill speed or whatever).  Then come back to their previous training intensity and then repeat that multiple times throughout the workout.

And I’d tell them to try to increase the duration of the harder bits gradually while reducing the times at a lower intensity.  Over several workouts, this would eventually have them working the full duration at the higher intensity.

Eventually, I might have moved some folks to true high-intensity interval training but, at least with the majority of this population, the progression they were seeing from doing the moderate stuff was sufficient that there was simply no need to bother with it.

So what about weights?

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Weight Progressions and Variations

With the routine I presented above, at the time I simply had clients doing a single set of 8-12 repetitions on everything, progressing weight as they were able.  So when they got to 12 reps fairly easily, I’d have them raise weight a bit, dropping reps and building them back up until they hit 12 again.  Rinse and repeat.  Very simple, very doable, very effective in the initial stages of training (keep in mind we’re talking here about folks looking at fat loss and general health so their strength goals are much more moderate than someone else).

Over time, they would usually start to push a bit harder of their own accord.  This was a very gradual progression and happened a lot as a function of the double progression itself.  Since they usually wanted to get to 12, especially as they got more confident in the exercises, they’ start pushing themselves a bit harder over time.  My only requirement was that they only did as many reps as they could do in good form.  But in addition, I’d often encourage them to get the next repetition when it looked like they were giving up a bit early.  Just to teach them that they had more in them and could work harder without dying.

Over time this taught them that they could push harder than they thought.  Over the span of  the first 4-6 weeks of training, they often got to where they working fairly close to their limits without ever having felt particularly overloaded; it just happened exceedingly gradually.  As well, as the weights got heavier, they might start including a single warm-up set prior to the main set.  This was time for another mini-lecture on the topic of appropriate warm-ups and such.

I’d note that, given my comments in previous parts of this series regarding the benefits of glycogen depletion on whole body fat oxidation and muscular insulin sensitivity, I’d be likely to do things differently now with this population of clients.  So rather than focusing on adding weight in a moderate repetition range, I’d probably be more likely to build the reps up to the 15-20 repetition range over the first couple of workouts still sticking with that single set.  Then I’d add sets.

So they’d still start with that single set of 8-12 and then rather than increasing weight, I’d probably push up the reps in good form and use a double progression in the 15-20 repetition range (such that the total duration of the set if 45-60 seconds, where glycogen is best depleted).  Just a consideration for trainers reading this series looking to apply the information from previous parts.

So rather than building up to the full 11 movements over the first week and then maintaining at a single set, trainers might consider sticking with the big 4 (or some combination) of leg press, chest press, row and something for core and start building the sets up, perhaps adding a set per week of 15-20 repetitions, to a maximum of 3-4 sets.

Done for 4 compound exercises (or even lower body, compound push, compound pull), that’s 12-16 sets. With a moderate rest interval, that can be accomplished in 30-40 minutes leaving time for other stuff (warmups, cooldowns, foam rolling, etc.).  And built up over the first 3-4 weeks, this will not only start to build the clients work capacity but do a good job of depleting muscle glycogen to enhance full body fat oxidation.

Combined with a lowering of calories/carbohydrates, this will start to retrain the obese client’s body to use fat for a fuel more effectively as discussed in previous parts of the series.  And is effectively what a lot of the metabolic type weight training workouts out there are attempting to accomplish.  I’m simply suggesting building up to it over the first few weeks rather than jumping straight into the full volume and killing people.

I’d note that, even within the context of my own basic 1 set routine, usually about week 6 or so, I’d either introduce them to some new movements or switch everything out.  This was often a time to move to more complex exercises if I felt they were ready.  It wouldn’t necessarily be a wholesale replacement, I might just change some movements and not others.

So rather than a machine chest press, I’d teach them a DB flat or incline press.  Rather than the row machine, they’d get a cable row.  Machine shoulder presses might become a DB overhead press or lateral raises and I might teach a different variant on the pulldown (medium overgrip rather than narrow undergrip).  As much as anything this was to prevent boredom (both theirs and mine), as well it gave them more options for when they were in the gym.

By getting them used to free weight exercises, this also gave them options for when they were traveling since machines can vary from gym to gym.  Sometimes they’d do the original workout one day and the new movements at a another.  Of course, they’d continue working on progression and such.  In some cases, clients might be moved to a basic split routine (if it fit their goals and schedule), a basic upper/lower kind of thing.

This was often useful for 30 minute clients as I could get them doing more movements and sets without running over the time I had for them.  So rather than 11 exercises for one set of a full body routine done every day, I could get them doing multiple sets of 5-6 exercises at each workout with a split routine of some sort.

I think you get the idea.  Basically the goal was to break them in without breaking them and then get them into a nice gradual progression such that by week 4-6 (past the time good habits are starting to get ingrained) they had actually developed some fitness and momentum without ever really breaking them.  By the time they had built their fitness up from a near zero baseline at week zero, they were often working far harder than they ever thought possible and had reached that point without ever feeling overloaded.

Intensifying things a bit at this point is not only a good idea but reasonable, they have the basic fitness to handle it now and should have developed enough confidence from receiving positive reinforcement to be ready for it.  It still needn’t be some major shock to the system, just a gradual increase in the workload (either frequency, volume, intensity or some combination) to get them moving to the next level of fitness and training.

If nothing else, it’s crucial to make clients of all sorts understand that progression is the name of the game.   People working at the same level endlessly aren’t getting fitter and usually aren’t getting leaner either (you can see this in any gym anywhere).  Teaching beginner clients about the critical need to progress over time is a key to the educational aspect of being a trainer.  It doesn’t have to be a continuous death-march to higher and higher levels of intensity and volume but over time things do need to progress to avoid stagnation.

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Summing Up

So finally, that would seem to wrap this up.  I know it took me a long time to get to the point and hopefully the information presented in this final piece was worth the wait.  I imagine some readers are wondering about diet, which I only touched on a little bit in previous parts of the series.  Frankly, there’s enough information elsewhere on the site regarding setting up diets and such that I don’t feel the need to rehash it here.

With most beginning clients, I tended to focus more on qualitative changes (e.g. making different food choices) to reduce their caloric intake rather than being on so much of a specific diet; much of this was because most simply weren’t that interested in making wholesale changes to their diet.

Certainly lowering calories and carbohydrates accomplishes some nice things and there is good reason to skew towards a higher protein/higher fat/lower carbohydrate diet in the obese/insulin resistant client.  But often just making some qualitative changes is sufficient to get things started (one thing I always emphasized was getting some protein at every meal).  More details and complications can be introduced as the client is ready for them.

A lot of this was just client dependent and covering that would take another full and overwritten article series.  I sort of touch on this idea in How Detail Oriented Do You Need to Be? basically distinguishing between the type-a ‘all the plumbing diet’ types of folks and those who want small manageable changes.  There are pros and cons to both approaches depending on the specifics of the client and the situation.

And that’s all folks.

After that I’ll talk about how I approached the first workout with obese (or non-) beginners in terms of structure and some generalities of training and such.  Finally (really, I mean it) on Tuesday I’ll truly finish up and talk about progressions, when and how to increase things and keep the beginning obese trainer progressing.

Let me note up front that some of what I’m going to write simply represents what I did/found to work in this population when I was working as a personal trainer, some of it will be more what I would do now were I still working with that population.  You’ll note that nothing really would change now except in degree (e.g. I might do things a touch differently in the weight room in terms of rep ranges or total volume).

With that said, and since I fear that some of my comments regarding exercise the obese beginner in Part 3 were misconstrued, so let me look at some of the myriad benefits of including both weight and cardiovascular training from day 1 in the obese beginning trainee.

Benefits of Weight Training

As I mentioned in Training the Obese Beginner: Part 2, an under-appreciated fact is that the obese frequently gain muscle mass in the process of becoming obese.  So while weight training can still play several important roles, putting an enormous amount of time and energy into it is, as I argued previously, somewhat misplaced.  You should do some, but you don’t need tons of it.  But ignoring that, what are some of the benefits of including weight training in the training of the obese beginner?

Well, one I already talked about rather extensively, depletion of muscle glycogen to start improving whole body fat utilization and fat burning pathways. Along with a lowering of carbohydrates/calories, this can exert a power partitioning effect by giving the fatty acids (floating around in the bloodstream) somewhere to go to be burnt off.

Quite in fact, as I discussed in Adding Muscle While Losing Fat – Q&A, I suspect that one of the reasons that over fat beginners can gain muscle while losing fat has to do with some of the dynamics of what’s going on physiologically secondary to obesity.  Now, realize that properly performed training is possibly the single most powerful tool we have to alter calorie partitioning (where calories go) with regular training increasing nutrient uptake into skeletal muscle in preference to other tissues.

So consider a situation where, secondary to whole-body insulin resistance, the fat cells are effectively pushing fat calories ‘away’.  If you give those calories a place to ‘go’ through training, the body seems to shift calories away from fat cells and into muscle.  Viola, fat is lost while muscle is gained.

I’d mention again that, as the obese already have gained some extra LBM in the process of becoming obese; specifically trying to gain muscle mass usually isn’t much of a worthwhile goal.  It happens but it’s really not the main ‘target’ in this population.  It is worth being aware of as small increases in muscle mass can often offset scale weight changes and make it appear as if fat loss is occurring at a slower rate.  This tends to generally only be the case in the very early stages of beginner training.

But beyond that, what are some other benefits of weight training in this population?  One has simply to do with correcting many of the imbalances that occur as part and parcel of daily life.  This was brought up in the comments to Part 3 and is important and worth consideration; never forget that health is (or at least should) be one end-goal of the whole process.  And modern life tends to cause a host of problems as a function of sitting all day, etc.  This can be corrected with basic weight training, improving folks’ quality of life.  Again, you still don’t need massive amounts of time or energy in the weight room to do this.

Back in my 20′s, I couldn’t count the number of clients I had with minor knee problems (especially females) or shoulder problems that had persisted for years that went away with even the most basic of weight training.  A set or two of end-range knee extensions and some basic shoulder re-balancing fix most of the issues unless there is an explicit injury; my clients always thought I was a magician when I fixed long-standing problems in 2 weeks with simple exercises.  Other issues of posture or whatever can be targeted through the simplest of programs just through some basic stretching and/or full range lifting (e.g. full ROM movements will stretch the involved musculature).

Beyond that there is another benefit to weights that I think goes very under-appreciated and it goes to the stuff I talked about in Training the Obese Beginner: Part 4 and that’s issues of positive reinforcement and adherence.  I found quickly that weight training, properly approached, provided a type of positive reinforcement for beginning clients that cardiovascular training just didn’t cause.

The problem is that aerobic adaptations tend to be fairly slow to occur, there’s just not the immediate bang for the buck that I found the typical beginner needed to make them feel good about what they were doing.  Even if they came out of every workout with positive affect, I needed to make them feel as if they were making progress and moving forwards immediately.  It might be 3-4 weeks before someone really ‘feels’ fitter on cardio and gets that first adaptation.  Given that some absurd percentage of beginners quit at the 3 week mark, that  was simply too slow.

But I got exactly that effect with weight training.  By approaching it in the way I’ll describe shortly, I made the trainee feel as if they had made improvements from the first to second workout.  As you’ll see, some of this was a bit of trickery on my part but, you know what?  I didn’t care.  Whatever got them coming back was more important than a bit of deception to make it happen.

And by picking exercises and weights that they could see immediate improvement in from the first to second workout, I generated a huge positive reinforcement effect.  Rather than feeling as if they couldn’t do exercise or sucked at it or whatever mental state they carried in with them (based on either pre-existing expectations or simply past experiences), I got them an immediate feeling of success.  Cardio didn’t do that quickly but weights did.

So there ya’ go, at least three solid reasons to include resistance training from Day 1 of training the obese beginner: metabolic, functional and psychological benefits.  There are probably more I’ve forgotten but, honestly, I think that’s enough reason to include it from the first day out.  Again, you needn’t put overwhelming amounts of time and energy into it but I do think that weight training should be part of the training of the obese beginner.

I bring this up explicitly because there is often an odd idea that the obese beginner should just focus solely on cardio to get fat/weight loss moving and worry about weights later.   But for the reasons I’ve outlined above and throughout this series, I think that including it in at least some form or fashion from the get-go is worthwhile.

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Benefits of Cardio

I mentioned in a previous part of this series that at least initially, most obese beginners have a very low tolerance for any sort of activity and this tends to include anything but the most low intensity cardiovascular exercise.  Even that is often problematic beyond a few minutes at a go.  As I detailed, this makes the expectation of burning a tremendous amount of calories or fat through cardio pretty much a pipe dream.  At least initially.

I would note, very tangentially, that several studies have found that accumulating activity throughout the day can generate, at least in the initial stages of training, benefits equivalent to doing it all continuously.  That is, 10 minutes of activity done three times per day generates at least similar effects to doing 30 minutes all at once.  For beginners with extremely low tolerance to activity, that’s one way to get a larger daily total without having any single bout be too overwhelming.

But beyond that, the only way to improve something is to do it regularly.  For that reason alone, doing some cardiovascular work from the get go is important.  Even if someone can’t do much to start, this will improve over time.  So in addition to any metabolic benefits on insulin sensitivity, caloric expenditure or whatever, the simple fact is that, over time fitness can and will improve.

So even if the obese beginner can’t do much to start with, they can gradually increase their capacities over time.  As they become fitter, they can do more in their training, driving fitness further, allowing them to do more.  It’s just one big feed-forward cycle if you do it correctly.

But what about benefits beyond that?  Perhaps one of the most important, and this also got mentioned in the comments, is overall adherence to the program, especially to diet.  This is something I’ve mentioned in several of my books but, at least in some groups, there is a mental association that tends to occur with activity and diet.  To whit, on days that people do some sort of exercise, they often stick to their diet better.  There is sort of this underlying logic of “I worked out, why would I blow my diet?”  In contrast, days without activity tend to be less predictable or be worse in terms of dietary adherence.

I’d note, and please realize that discussing in detail this would take another overwritten article series, that this is a very complicated issue and how exercise does or does not affect things like dietary adherence or appetite depends heavily on the psychology of the dieter and a host of other factors.  More specifically, we’ve all known those people who justify that they ‘earned that cheeseburger and milkshake’ because they worked out, usually based on the faulty assumption that they burned far more calories than they actually did.

But that’s an issue of education as much as anything else (there is related issue of individual psychology that I’m not going to get into) and making people understand that they did not in fact burn 1000 calories with 30 minutes of brisk walking.  Or even an hour aerobic class.  Or in anything that they are currently capable of.  And in also making them understand that they can all too readily offset (and then some) any deficit from activity if they don’t keep their diet under control.

But assuming they understand that, for many people a day that they exercise is a day that they are more likely to adhere to their diet.   That’s good, especially given that dietary modification may be the most important target to work on in terms of getting fat loss started anyhow.

Finally, as you’ll see below and in Part 6 on Tuesday, I used cardio sessions during the hour as a time to give mini-lectures.  I had a captive audience and I could teach them about things like training (I’ll give an example below) or talk about diet or what have you.  Not that I’m suggesting that you necessarily use that part of your hour to do that, but it is another possible way to put cardio to use beyond the most commonly thought of purpose (burning calories and fat).

So there you have multiple benefits to including cardio in the program from day 1. There are the obvious metabolic effects, the simple fact that the only way to improve fitness in an activity is to do it and possible adherence issues.  Trainers can also use it as a time to educate their clients while they have them captive and aren’t worrying about details of the weight room.

Now let’s talk about how to put this all together which I’ll start today and finish on Tuesday.

First I’m going to outline what I did years ago with clients.  I’d probably do some minor things differently if I were going about it again today but the differences would be mainly in details more than anything else.  The overall structure of how I approached it or think it should be approached wouldn’t change.

I’m also not saying that what I’m going to write is the only way to go about things. Clearly there are a lot of workable approaches within the issues I’ve tried to address in this series.  This was simply mine (much of which was a function of the gyms I trained in, what I had access to, etc.)  Just focus on the principles of what I’m talking about; don’t get hung up in minor details.

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The First Workout

Most trainers work on a 50 minute hour more or less.  And all too often make the mistake that if they have an hour of training, they need to fill it up to ‘give the client their money’s worth’.  There is some truth to this (it’s hard to keep someone coming back and writing the checks if you make them sit around half the session) but in the beginning stages, you have to forget that stuff, the goal is not to beat on them for an hour.  The goal is to break them in without breaking them as I discussed at length (ad nauseum) in Training the Obese Beginner: Part 4. Obviously I did not do this.

Anyhow, here was my ideal first ‘hour’ session:

Spend 25-30 minutes on intake paperwork.  Just the various pieces of information, including injuries, health risks, a quick look at diet, etc. that needed to get done so I knew what I was dealing with and if there were any major issues.  For anybody who’s interested, I’ve uploaded a zip file of the exact paperwork I used.  Click here to download it.   If I were doing measurements of any sort (skinfolds or tape measure), I’d do them here at the very end of things.

I’d note that, as I got more experience as a trainer, I often did away with the measurement part of the initial consultation.  For the very obese, not only are the measurements pretty useless, they can be embarrassing which is not what you want out of the gate.  In many cases, you can’t get a good measurement anyhow.  Trying to get a good skinfold on the thigh of an obese woman is pointless; you won’t get a good measurement, odds are you’ll make her feel really embarrassed and it’s simply not something worth doing in my opinion.

They also don’t really tell you anything, as I discussed in Initial Body Fat and Body Composition Changes, almost any weight loss in the obese is from fat assuming the program is not completely moronic.  Taking skinfolds doesn’t tell you anything useful and may be a negative psychologically.  If the clients weight is going down, most of it will be fat.

Even if some of it is LBM, if they are weight training, it’s most likely inessential LBM and glycogen/water.  Basically, simply stepping on the scale tells you most of what you need at this point.  At most I might take tape measure measurements but only to show how much they had changed at the 6-8 week mark.  This can be useful since often weight won’t show a major change initially although inches are being lost (e.g. fat is being lost while some muscle is being gained and offsetting the scale drop).

The same goes for exercise testing.  Testing a max bench or leg press or whatever nonsense on day 1 is simply pointless in this population.  It tells you nothing since most will improve by the second workout just based on practice alone and given that the goal is to start sub-maximally, there is simply NO logic to putting a beginner through a maximum exercise test of any sort.  Most flexibility evaluations are worthless too.   Just do the paperwork, maybe take a tape measure measurements and get them on the floor.  The rest of it can wait until after the first block of training.  And that’s what I did.

And following that initial bit of paperwork, I’d take them through 20-30 minute workout.  Yes, that’s right I ‘wasted’ the first half of their first session with paperwork and such.  But it wasn’t a waste in my opinion.  It was information that I needed in the first place and I universally found that 20-30 minutes of activity was about the most that the typical beginner (obese or not) could handle.  Think about it this way, a coach starting with a new runner might have them go 20 minutes easy on their first day.  Possibly less than that.  What makes you think an obese beginner needs more training than that other than the fact that you work on a billable hour?

And with only another 25-30 minutes to actually train them, it let me break them in without breaking them, I could have them do just enough to get started and walk out of the gym feeling good without doing too much so that they were wrecked.  Again, there are always exceptions.  I get an athlete or someone with a previous sports background and I’d do it differently.  But in this population, the rank newbie (again, obese or not) 20-30 minutes was about right.

Quite in fact, I often did 30 minute workouts with people in the long-term.  As I mentioned in Training the Obese Beginner Part 3, that’s plenty enough time to do the weight training they need to do.  Assuming that they will do metabolic work on their own, I saw no point in charging them for me to watch them do cardio.  So I’d often do 30 minute workouts with them.

So specifically what did I do in that first workout and how did I progress it over time? Tune in Tuesday when I will finish this silly series up or die trying.

Read Training the Obese Beginner: Part 6

Anyhow,  in Training the Obese Beginner: Part 3 I basically summarized everything to date to conclude that the best approach to target all of the various issues going on was a combination of progressive volume higher rep weight training (to deplete muscle glycogen) along with dietary modifications (both carbohydrate and/or calorie reductions) with progressive amounts of cardio as fitness improves to both burn of fatty acids directly and start to retool mitochondria to overcome that defect.  All wonderful (and a nice run-on sentence), but how to practically go about it?

That’s really what I’m going to get into Friday, today is more of an examination of how not to go about things.  Sort of.  Just read.

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Breaking them In without Breaking Them: Part 1

As I noted in Training the Obese Beginner: Part 2 and talked about in the Beginning Weight Training series (in a different context), most beginning trainees have a low tolerance for training.  And at least one goal of the initial phases of working out is (or at least should be), to get them in shape to be able to actually train.  I realize that this sounds illogical but trust me it isn’t.  Related to this is getting them into the habit of regular activity.

In the initial stages of training, consistency is really more important than anything else.  It’s about forming habits, you can worry about issues of volume, frequency, intensity later.  But first and foremost you have to get people showing up on a regular basis.  Because the most brilliant training program isn’t worth a damn if the person isn’t there to actually do it.

And don’t read this as one of those silly things that occasionally gets voiced “Oh, I’ll join a gym after I get into shape.” by people.  I’m saying that you can’t really train someone effectively (in the sense of really training them hard enough to improve physiological qualities) initially until you get them in shape first.  Well, you can, in that you can always beat the hell out of them before they are ready for it.  But only if you want to hurt them or make them quit.

I’d note that this isn’t specific to the obese client, it really applies to anyone new to training whether the goals are related to sports, performance or simply changing body composition. Anybody new to training needs a break-in period to get them prepared to train effectively.

However, there are often some subtle motivational and psychological differences between the ‘average’ obese beginner and the wannabe psycho motivated would-be athlete or bodybuilder or whatever that I think many people tend to forget.  And that I want to look at briefly.

In the second case, that of a motivated individual, the psychology is often such that even if you beat up on them the first day, they’ll come back for more.  They want to be there, they want to be big, they want to be strong or they want to perform at the highest levels of their sport.

They want desperately to be in the gym getting their brains beaten in to get to their goals.  So you can beat the crap out of them and they’ll come back for more.  I still think it’s a bad idea to do it that way but you can usually ‘get away’ with it without chasing them off.  In many ways, they’ll probably equate getting beaten on with reaching their goal anyhow.  So they keep coming back.

That’s quite often very different than the situation I’m addressing in this article series, the obese beginner who, with all likelihood not only has a low exercise tolerance but probably doesn’t really want to be exercising for whatever reason.  Perhaps they had previous bad/failed experiences with trying to work out; odds are that part of what put them where they are in the first place is a general dislike/disillusionment with exercise.  Maybe they are just wired that they don’t enjoy it, or just expect it to be miserable.

It doesn’t ultimately matter, the point is that this is a population that doesn’t want to be there in first place as often as not.  Basically, in contrast to the psycho who wants to be in the gym, in the typical obese beginner, you’re dealing with the diametrically opposed psychology.

And in that population, if you beat up on them the first day, odds are they won’t ever come back.  Not unless you got them to pay for the big personal trainer package up front.  Sometimes not even then.  Even if you know you have them for the next month, beating on them out of the gate is still usually not the best approach in my opinion.  This is most of what I’m going to talk about today to set up for the big finale on Friday.

In general, I think it’s fair to say that most who become personal trainers tend to come from the motivated psycho athlete population.  This isn’t universal of course but I daresay it’s more common than not.  I fear that they often don’t understand the psychology of someone coming from the obese beginner population; they were never there themselves and can’t understand someone who is.

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Breaking them In without Breaking Them: Part 2

Now I know that some trainers operate this way and that some of them seem to make it work.  I once asked a trainer I knew “So how do you keep them coming back if you make them too sore to move on day 1?”  His answer, in a deep Scottish Brogue was “Oh, we get the money upfront, it doesn’t matter what we do; they’ve paid enough that we know they’ll come back.”   No wonder he has to steal other people’s work, he doesn’t have a clue.

In any case, my goal in training that second population, the non-motivated beginner trainee was always this: I wanted to break them into training without breaking them, to make them realize that exercise didn’t have to be miserable and exhausting and soreness inducing, so that I’d keep them coming back consistently.  As noted above, that’s more important than anything else in the initial stages: keep them coming back consistently enough so that exercise becomes a habit.

That allowed me to, over time, gradually increase the workload and move them to higher levels of fitness without ever feeling like they were really being beaten up.  And I did it while getting them into good exercise habits by doing my best to ensure that they came back long enough to start realizing benefits and actually wanting to be there.

Towards that goal, every workout was meant to be a little bit of an improvement over the last one (so that they got positive reinforcement and felt successful in what they were trying to do) without ever really breaking them.  By the time they reached a fairly high level of output and work performance, they had never really felt the increases because they were so gradual.  It just sort of snuck up on them.

To be honest, I wasn’t aware of any of the science or research that I’m going to bore you with below; that’s just what made sense to me.  Either I was just lucky, or somewhat intuitive, or simply didn’t have my head completely up my ass when it came to thinking about this stuff.  But I didn’t see the logic of beating the crap out of a rank beginner and making them so unhappy that odds are they wouldn’t come back.

Basically, and this can be tough, you have to take the long view on certain things.  Because while beating up on them in the short-term may accomplish some things (some good, some bad; mostly bad in my opinion), the long-term results are at risk.

The Biggest Loser is a good example, to harp on that point.  What happens when someone who has lost a ton of weight with 4+ hours of training per day and a massively restrictive diet gets in a situation where that’s not feasible?  They have no idea where to go because the only approach they know is one that is simply unrealistic in the long-term for most folks.

Again, there are always exceptions to this, I’m speaking here in generalities.  There are a time and a place for extreme approaches out the gate (as I discussed in Is Rapid Fat Loss Right for You, some data suggests that faster initial weight loss leads to better long-term maintenance but that’s diet, not exercise and it’s predicated on knowing how to move to maintenance afterwards).  And, generally speaking, my feeling is that it’s better to take somewhat of the long view, especially with regards the exercise program to give a better chance of long-term adherence.

Because, if instead of beating the crap out of them on day 1 and every day following, instead, you take the long-view and build up progressively and keep them coming back consistently without ever feeling like it’s miserable or terrible, the odds of getting them into good habits goes up.  And that leads me into my last irrelevant tangent for the series (famous last words).

Ok, that dead horse has been beaten, now it’s time to really bore the hell out of you.

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Affect, Self-Paced Exercise and Self-determination Theory Part 1

Affect is a psychological term, think of it very simplistically as how you feel either during or after an activity (I’m sure at least one reader with a psych background will take issue with this extremely broad definition; I can live with it).  So if you watch a sad movie and come out of it sad, that might be termed a negative affect.  If you watch a Will Ferrell movie and come out of it laughing and happy, well, two things: First that’s a positive affect, you felt better afterwards.  Second, you have terrible taste in movies and no sense of real comedy because that guy is about as funny as a heart attack.  But I digress.

In the beginning trainee (and whether this is specific to the obese trainee or not is not relevant here), generating a positive affect from exercise is important, at least assuming you want them to continue doing it.  Because as a generality, people don’t tend to continue things that make them feel bad.

And if the first day out of the gate, a trainee comes out of exercise feeling miserable, exhausted, like a failure and wakes up the next day too sore to move, that’s going to generate a negative affect; both during and after the training session.  Basically they will have a negative response to what they are trying to change in their life.  In general, that is not consistent with generating long-term adherence.

To beat this dead horse down, if I make you do something every other day that does nothing but make you feel miserable (on either a psychological or physiological level), do you consider yourself likely to continue doing it?  Probably not.  Of course, there are exceptions; that odd subculture of folks who equate pain and suffering with positive outcomes. They are usually called athletes.  Or masochists.  Not that there is really a difference.  But that’s doesn’t apply to the majority of whom I’m talking about.  Or the majority of mentally balanced individuals.

I bring this up as what I see far too many trainers do (and some trainees do in fact ask for this) is bring their beginner clients (obese or not) in and just beat the piss out of them on the first day. Watch any first episode of the Biggest Loser for an example, or just watch the gym and see what the trainers often do with clients on the first day.

There are usually a few things going on here that I think drive this type of mentality.

The first is that the trainer has forgotten what it was like to be a beginner.  I see too many trainers assume that what they are doing now (10 years into their own training) is what everyone should do. Basically they know how to train themselves but have forgotten how to train a rank beginner.

Even there, as I mentioned above, even as beginners they probably started out in the psycho motivated camp I mentioned above; they didn’t mind being beaten up as they wanted to be there and be big or buff.  They don’t understand what someone who doesn’t have the drive is going through even being in the gym in the first place.  They’ve never been overweight (a point I’ll come back to in Part 5) or self-conscious about exercise so they can’t understand why anybody else would be.

A second issue is that trainers often have this underlying need to ‘strut their stuff’ really show the trainee that they know what they are doing.  That means putting them through their paces and beating the tar out of them to show them how good they are.  No.  Bad trainer.  Bad.  You can show them how good you are AFTER you get them into a consistent routine.  Day 1 is not the time.  Neither is Day 3 or even week 3.  Beginners don’t need anything but the simplest stuff to get moving anyhow.  There’s just no point to putting them through complex high-volume or high-intensity training out of the gate.  It’s not necessary and is likely to have a negative rather than positive effect for most.

Of course, as noted, some clients want this and ask to be put through the grinder assuming that more is better and harder is better (thank you Puritan work ethic).  And trainers, who usually don’t know better, are often happy to oblige, feeling that they should give the customer what they want.

But part of being a trainer in my opinion is education and knowing what’s right or wrong for the trainee (this goes for coaches too, athletes usually don’t know what they need; if they did they woudn’t need the coach and it’s his job to tell the athlete when to shut up and listen).  If that means educating them to do less (at least initially) rather than more, that’s what they should do.  Not pander to the client’s (confused) belief about what they should be doing.

Ok, where am I going with this?

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Affect, Self-Paced Exercise and Self-determination Theory Part 2

So let’s assume for a second that the goal of exercise is to generate a positive affect, working from the assumption that this will give the greatest likelihood of keeping the person coming back and getting into a consistent routine.  Which is not only fairly common sensical but supported by the research.  How do we do that?

Research on exercise (mostly aerobic) has found that certain types of activity are more likely to generate a positive affect in beginners/the obese than others.  I’d note that some other, really complex studies, find that differences in brain function suggest individual differences in how people’s affect change with different types of training but that’s far more complex than I have space to get into here.

In one specific study, exercise below, at or above the ventilatory threshold (essentially the same as the lactate threshold, a bunch of other stuff as discussed in Predictors of Endurance Training Performance) were examined for its impact on affect after the training.

The study found this:

1. Exercise below the VT was associated with a positive affect; that is most people came out of it feeling good about it.
2. Exercise at the VT had the most variable response, some positive affect some negative affect.
3. Exercise above the VT generated negative affect, most people finished feeling bad about it.

This isn’t really surprising except for maybe #2.  The explanation for that has to do with internal motivations and individual variance.  Some people, and this has to be judged on a case by case basis, don’t feel good about an activity if they don’t feel that they actually did some work.

That is, some folks find that stuff that is too easy feels like a waste of time.  For them, working closer to VT generates positive affect; for others it doesn’t. But universally working below VT generated positive affect.   And universally, working above the VT was a negative.  Other work, using the lactate threshold (which is effectively the same as the VT) shows the same basic response; work below is consistently met with positive affect, work at with highly variable affect, work above with negative affect.

Quick question for all of the interval freaks: where do you think intervals fall relative to VT?   What type of affect do you think it will generate in an untrained beginner?  Why do you think even the researchers studying this point out that “While these results are interesting, the intensities used are far beyond what a beginner can be expected to sustain?”

Seriously, knock that shit off.  Even highly trained athletes don’t really ‘enjoy’ interval training; they do it because it has to be done.  But it doesn’t generate a positive affect; it’s simply that the benefits are worth the suffering.  For the obese beginner…well, knock that shit off.

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Affect, Self-Paced Exercise and Self-determination Theory Part 3

Now, the above, and this was actually the topic of the monster paper (with the title “Exercise, affect, and adherence: an integrated model and a case for self-paced exercise.“) I have in mind was dealing with the idea of using self-paced exercise (that is, allowing the trainee to pick their own comfortable pace for exercise) as a way of ensuring positive affect from it. That is, rather than pushing them to do something that makes them feel miserable and generate a negative affect (impairing compliance), let them pick the pace they want to give a better chance at positive affect and longer term adherence.

Interestingly, left to their own devices, most people will pick a pace that is near but below their own individual VT/LT discussed above.  Basically they tend to pick a pace that’s challenging but doesn’t generate negative affect for them.  The paper makes a strong case that allowing that type of self-pacing of exercise may be better than using more traditional methods (e.g. based on heart rate or VO2 max or heart rate reserve).  Especially given that, in the untrained beginner, things like VT/LT can vary so much that any stock standard intensity gauge (e.g. 70% of maximum heart rate) may put them well out of an exercise intensity that will generate a positive affect.

An additional benefit of allowing beginners to self-select their exercise intensity ties into something called self-determination theory (SDT) which, very broadly, refers to the idea that people who feel as if they have some control over what they are doing and the outcome do better than those who don’t.  Basically, people do more poorly when they feel as if they are just being told what to do rather than having some input over their own program or diet or what have you (at least one recent study showed massively better results with a diet group that applied SDT).

Of course, a counterargument to this is that, left to their own devices (and you can prove this to yourself in any gym by watching folks), most people will piss around for weeks or months without ever working outside of their comfort zone which is an equally poor approach at the other extreme; they’ll ‘walk’ on the treadmill at some irrelevant intensity and never push the pace at all and wonder why magic doesn’t happen.

You have to find a middle ground (some of which involves educating the trainee about the need for progressive overload, etc.)  That goes back to education (from a trainer’s perspective) making folks understand that as they get comfortable with things, they have to start working harder.  Again, I’ll come back to that on Friday in Part 5.  But that’s an issue for the longer term, not for training the obese beginner.  In the beginning stages, letting folks self-select intensity would seem to provide the best benefits and fewest negatives in terms of long-term adherence type issues.

Again, mainly here I’m talking about the initial phases of training, how to get someone who has a low tolerance for activity and likely doesn’t want/like exercise, to keep doing it.  And that means having them finish EVERY workout on a positive note and feeling as if they’ve not only accomplished something, but are progressing and feel as if they have some input over the program.  But you do have to strike a balance here.  But it appears that, at least with aerobic training, there may be some real benefit to allowing a self-paced intensity to be used.

Resistance training is a touch more complex, mind you, since self-selection of intensity can go all kinds of different ways (usually males will try to work far too hard and women won’t work at all). There I find that trainers have to exert a touch more control over things but I’m getting ahead of myself.  That’s what I’ll discuss when I finish up on Friday.

Read Training the Obese Beginner Part 5

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One More (Irrelevant) Tangent: Fat Loss vs. Health

Mainly throughout this series, I’ve focused on fat loss as the primary end-goal for the obese trainee but it’s worth noting that this is absolutely NOT the only (or even necessarily the primary/best) end goal when we talk about training and dietary modification.  Certainly it’s the one that most people are concerned about but that doesn’t mean that their approach is the correct one.  What I’m getting at is that there is the whole health thing to consider.

And in that vein studies clearly show that even small weight losses (as little as 10% of current weight) can drastically improve health parameters.  So even if someone never achieves a ‘normal’ or ‘ideal’ (two very loaded words) weight or body fat percentage, that doesn’t make that act of losing weight/fat useless; it may still improve health significantly.

And in that vein, some studies have even suggested that people who remain overweight but are regularly active may be healthier than folks who are skinnier but inactive. Please please note my use of the word ‘may’ in that sentence.  This is an issue with very mixed data that is contentious as hell.  More research is needed so don’t bitch me out in the comments for saying something I didn’t say.

In any case, some are now talking about metabolic fitness (in terms of physiological parameters such as insulin resistance of blood lipids or blood pressure) versus things like physical fitness (VO2 max or body fat percentage).  Again, it may very well be possible to improve health and reduce disease risk even if fitness per se isn’t improved and fat loss per se doesn’t occur.

.Back to the Series

But I started this series with a focus on fat loss as an end-goal and I’m going to continue with that primary focus.  So here’s a quick summary of the issues I’ve discussed.

In  Training the Obese Beginner: Part 1 I looked at the following:

1. Insulin Resistance/Metabolic Syndrome
2. A high resting/exercise RER (indicating decreased fat use for fuel)
3. Impaired Mitochondrial Function
4. A low tolerance for activity (as a function of low fitness and the realities of physics)

In and Training the Obese Beginner Part 2, I continued by pointing out:

1. That the obese typically have increased muscle mass
2. That the obese typically have an increased resting metabolic rate
3. Some of the realities or exercise including realities about caloric expenditure and an often lack of enjoyment of exercise (on top of the generally low tolerance for it)

So let’s put it together, given these situations, how to practically approach training the obese beginner to overcome this.  First let me focus on the physiology a bit.

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Becoming a Fat Burning Machine

I want you to know that typing that heading made me die a little bit but that’s how it goes; it’s just such a trite, cliched and worn out phrase.  As I mentioned, a common finding is that the obese individual often has a lot of fatty acids floating around in the bloodstream (secondary to insulin resistance at the fat cell) but tend to rely more heavily on glucose and carbohydrate  both at rest and during exercise for various reasons.

Some of this is certainly genetic, some of it is due to low activity/impaired mitochondrial function and a lot of it is related to diet with a chronically high carbohydrate intake promoting high carbohydrate oxidation across the board, secondary to increased muscle and liver glycogen stores (along with increased insulin levels due to the combination of high carbohydrate intake, high fat intake and insulin resistance).

The solution to this is multi-fold.  Obviously diet is a clear place to make changes.  Reducing carbohydrate intake with an increase in protein and dietary fat (protein can raise insulin but fat is relatively neutral) is a good first step.  I’m not even saying that a full blown removal of carbohydrates is required, simply a reduction.

Often times this can be made by making merely qualitative changes in the diet, simply replacing certain foods with others, without having to make actual quantitative changes.  This is mainly accomplished by getting a food diary (or just having a client walk you through a day’s eating) and looking for major red flags.  Places where simple changes can be made that will have big impacts overall.  This approach often has the end result of lowering total calorie/carbohydrate control without the person feeling like they are ‘on a diet’.  Which can help to avoid the psychological stress of ‘being on a diet’.

But doing this, lowering carbohydrates and raising protein/fat/fiber (every meal should contain all four nutrients) tends to give better blood glucose and appetite control, lowers insulin levels (improving glycemic control), generally improves a number of metabolic parameters etc.  Something approximating the Zone as a first step perhaps, 25-30% protein, 30-40% carbs and 25-30% fat; years ago something to that effect was proposed as the optimal diet for treatment of the metabolic syndrome and it’s just as relevant today.

Somewhere in that range in any case.  Ignoring the fact that I don’t like percentage based diets, of those numbers, protein should come from mixed sources with most of the fat coming from monounsaturated sources (e.g. olive oil, oleic acid, etc.) and the carbs probably needing to come from lower down on the glycemic index scale (this tends to be less important as the quantity of carbs goes down but many find better satiety from lower GI carbs).

In some extreme situations, a full blown ketogenic diet (100 g carbs/day) may be necessary to overcome massive insulin resistance.  It can also help by eliminating a lot of the ‘trigger’ foods that cause problems with food control for folks.  That is, as I talked about in the Comparing the Diets series, many people just can’t do moderation.

If they eat some carbs, they want more carbs (this is highly individual but not uncommon with the obese individual).  Cutting out everything but vegetables and fruits can go a long ways towards long-term food control and reprogramming food preferences (just expect them to bitch for about 3 weeks as their taste buds and such adapt).  Especially initially (often times other foods can be added back in after taste buds adapt and the person is on a good rhythm of eating habits).

Of relevance to fat oxidation, a lowering of carbohydrate will not only reduce carbohydrate oxidation but also help the process of lowering glycogen stores within muscle and liver.  As that occurs (and I’ll talk about training next), the body will start to increase whole body fat utilization.

Studies years ago (I cited them in The Ketogenic Diet) found that full body glycogen depletion (via training) enhanced whole body fat use in both the lean and the obese.   I used this strategy for very lean folks in The Ultimate Diet 2.0 but it has relevance here as well to start correcting a ‘defect’ that has occurred.

And this is one of several ways that weight training can play a role (there are others that I’ll come back to below), it’s one of the best and fastest ways to deplete muscle glycogen and start getting fat burning pathways running again.  Generally a focus on higher repetitions (more accurately sets lasting about 45-60 seconds) is the goal here. So you’re looking at 12-15 reps on a slow tempo or 15-20 with a faster tempo.  In that range.

Multiple sets would be ideal (to fully deplete the body quickly takes about 12+ sets per muscle group) although it would be a massive mistake to try and do this out of the gate with a beginner.  But over the first week or two, with a gradual increase in volume over that time period will get the job done, it will just take a bit longer.

You don’t even need a ton of exercises, pick compound movements like leg press, chest press and rowing or pulldowns and you’ve got most of the body.  A routine centered around 3-4 sets of 12-15/15-20 repetitions might take as little as 30 minutes.  I’ll talk about exercise selection in part 4 when I will finish up (promise).

Of course, cardio, even with the limited amount that can be done also starts helping with this process.  As I’ll talk about on Tuesday, while the typical obese beginner trainee has a very low tolerance for exercise (and usually not much enjoyment for it), both can be improved over time with the right approach.

And this will have two effects: one of which is to help to burn fatty acids directly (and this effect will increase over time as fitness improves and glycogen is depleted), the second is to start readapting mithochondria to overcome that physiological ‘defect’ of decreased mitochondrial function.  This is a slow process mind you but it will happen with consistent work.

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Is that All?

In a sense, yes.  All of this blabbering to tell you to lower carbohydrates and calories, deplete glycogen with progressively increasing volumes of high-rep weight training and ramp up cardio over time.  From a purely physiological standpoint, that’s really the approach that I’m talking about.  But it would be silly to think that that’s all there is to this topic.

But, as usual, there’s more.  There are other practical issues that must be addressed and this means going a bit backwards to look at some other issues of relevance to the obese beginner.   But since covering it all in this post would make it too long, I’ll cover that next Tuesday in Part 4.

Read Training the Obese Beginner: Part 4.

As usual, my goal of finishing in two parts was unrealistic, this will have to finish up on Thursday in Part 3 when I”ll put it all together and talk about practical implications/applicational stuff.  For now I want to look at a few more physiological issues including increased muscle mass in the obese, a brief look at metabolic rate (mainly a myth-buster thing) and then finally at some of the realities of exercise.

Increased Muscle Mass

One of the consequences of becoming obese, surprisingly enough, is that a portion of the total weight gained is lean body mass (LBM).  On average, of the total weight gained, LBM may make up about 25% of the total.  So if someone puts on 100 pounds of weight, and this is without training mind you, as much as 25 pounds of it could be expected to be LBM.  I’d note that this process is not unlimited, even the very obese seem to hit an upper limit of LBM; above that point further weight gain is almost pure fat.

In any case, I’d also mention a portion of this LBM is actual skeletal muscle.  Ever notice the leg and calf size on bigger folks?  Huge with the strength levels to match.  Think of becoming obese in the long-term as the ultimate in progressive overload, the increasing body weight acts as an overload for lower body muscles and they hypertrophy in response.

But not all of it is actual muscle tissue, some of it is what researchers are now calling inessential LBM.  Basically it’s increased connective tissue, glycogen, water, etc. that is gained as body weight increases.  It’s also usually accepted among obesity researchers that, because of this gain, up to 25% of the total weight lost can come from LBM.

That is, unlike in the situation with leaner individuals, where LBM loss is a problem that needs to be dealt with/stopped in its tracks (since the majority of that LBM is skeletal muscle), loss of LBM in the extremely obese is less of an issue.  Quite in fact, to achieve a ‘normal’ body weight (whatever exactly that means), loss of some of the ‘extra’ LBM may be necessary.

Basically, what’s being lost is what was gained in becoming obese in the first place so it doesn’t matter in the big scheme.  Not all agree, some differentiate losses of inessential LBM (glycogen, water, minerals, connective tissue) and essential LBM (muscle mass, etc.).  The first can be lost without concern, the second maybe not so much.

So why am I bringing this up other than to show off my incredible knowledge of useless physiological minutiae?  Here’s why:  In training the obese beginner, individuals with a proximity bias for the weight room often put a lot of their energy into having the obese lift weights.  They figure that’s what should be done in the gym, and that’s what they like to do, so that’s what all their clients do.  And it tends to be a real waste of time and energy beyond a certain point.

Some of this also comes from the still gross misconception that ‘muscle burns a ton of calories’ (a myth I took apart in Dissecting the Energy Needs of the Body – Research Review).   That is, they hope to jack up metabolic rate by increasing muscle mass.  Which is a futile activity because the effect is minimal (on top of the fact that the obese are already carrying extra muscle mass).  A pound of muscle burns about 6 calories at rest, you have to add a ton to impact on metabolic rate (see also the next issue I discuss, low metabolic rate isn’t a problem).  And that takes a lot of time, time better spent focusing on active fat loss.

Which segues into the misguided notion that increasing muscle mass will automatically lower body fat percentage, which I took apart in Reducing Body Fat Percentage by Gaining Muscle – Q&A.  Losing fat always has a much larger impact in this regard as the math clearly shows.  Gaining five pounds of muscle has a negligible impact on body fat percentage (and health parameters in the obese) compared to losing five pound of fat; and the second can be accomplished in a fraction of the time (weeks for the fat loss versus months for the muscle gain).

I’d also note that, in terms of time spent, you can pretty much always burn more calories during cardiovascular activity than in the weight room, not that you can burn a lot with either under most conditions (see the final topic today).  And before you bring up EPOC/the afterburn effect in the comments, go read Effects of Exercise Intensity and Duration on the Post Exercise Oxygen Consumption – Research Review. The impact is minuscule approaching irrelevant: the calories burned during activity are the major contributor no matter what you do.

Which isn’t to say that weight training isn’t important or useful for other reasons (which I’ll cover in part 3). My point is that spending an inordinate amount of time on weight training with the obese beginner is simply a misdirected effort.  It’s time spent that is unlikely to massively impact on the outcome but will take time away from other, relatively more important activities.  Should you do some?  Yes, absolutely.  Should you do tons?  Generally not.

I’d note that even in the Biggest Loser Feedback piece I ran, the writer mentioned that their training was about 25% weights/75% cardio.  I could even see a more skewed ratio but the Biggest Loser is mostly about doing what looks good on tv, not what is the right kind of training.  And watching people do cardio isn’t very exciting so they have to dick around with weight training stuff to get an hour’s worth of television out of it.

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Metabolic Rate

While this doesn’t really have a huge practical impact, I want to mention it today since I brought up metabolic rate above.  There is a long-held belief that the obese suffer from a low metabolic rate, this idea has been maintained for decades now.  Now, I would mention, and readers who want more detail should read Metabolic Rate Overview, that there are four different components to metabolic rate and the one I’m talking mainly about right now is resting metabolic rate (RMR).

But this idea, that the obese have a massively low (for their weight) RMR, long-held, is simply wrong.  Outside of weird pathologies (e.g. the handful of leptin deficient folks), the simple fact is that studies find what you’d logically expect: larger bodies burn more calories at rest (as well as during activity).  That is, the obese have higher resting metabolic rates than their skinnier counterparts.  In fact, a recent paper mentioned that the never-ending search for proof of a lowered metabolic rate in the obese led obesity researchers down the wrong path for years; they were looking for a non-existent phenomenon.

I would note that one risk factor for becoming obese in the first place is a lower than predicted metabolic rate.  That is, some people, BEFORE they become obese, have a lowered metabolic rate relative to what you’d expect based on their weight; this tends to be due to lowered sympathetic nervous system output (at one point it was stated that most forms of obesity known were related to low sympathetic nervous system output) although thyroid dynamics can also a play a role.

And this lowered metabolic rate tends to predispose them towards weight gain under certain conditions (such as the modern environment).  But by the time they become obese, this initial ‘defect’ has reversed itself; larger individuals have higher metabolic rates than smaller (though there is still some variability at any given body weight).  You simply do NOT see obese individuals with exceedingly low RMRs.  Again, not unless there is some massive metabolic problem (such as leptin deficiency) and that can’t be attacked with diet and training anyhow.

Now, I’d mention again that I’m only talking about RMR above which is reliably increased in the obese individual; but RMR only makes up about 65-75% of total daily energy expenditure.  The others play a role.  However, some of the other components of total energy expenditure, such as TEF (thermic effect of food) or the thermic effect of activity are often decreased.

TEF can be cut in half due to insulin resistance for example.  On a 3000 cal/day diet, for example, where you’d predict TEF to be 300 calories (10%), it might be cut to 150 cal in someone with insulin resistance; which I noted in Part 1 is common in obesity.  While this isn’t a massive effect, it does add up over time.

As well, daily activity is often decreased in obesity.  Larger individuals simply tend not to move around as much as their leaner/lighter counterparts (an old experiment is to go to the mall and see who rides the escalator and who takes the stairs for an example of this).  So even if RMR may be higher due to the larger body, total energy expenditure may still be lower than expected due to a decreased TEF and reduced overall daily activity.

Again, none of the above is really relevant to the practicalities of the obese beginner, at this point I am just showing off my knowledge of physiological minutiae.  I’m also an obsessive compulsive completist with a need to destroy long-standing and utterly silly myths and this is one of them.  Moving on.

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The Realities of Exercise: A Primer

In Training the Obese Beginner: Part 1 I mentioned that generally low exercise tolerance is common among the obese.  Note that common doesn’t mean universal.  Once again, the Biggest Loser show notwithstanding, expecting a beginning obese client to do a ton of activity out of the gate is usually a mistake.  And one that often backfires.  Sure, you can make them do it but just because you can doesn’t mean you should.

And one of the realities (and in fact ironies) of exercise is that usually the only people who can burn a ton of calories with exercise are folks who are already well trained (and usually don’t need the calorie burn).  That is, trained athletes can burn a massive number of calories in exercise fairly readily.

Even an hour of moderate activity may burn 600 calories, and they can do that for hours at a time. An hour of hard activity may put them nearer 900-1000 calories though it can’t be sustained for quite as long a time.  But they are usually already lean and don’t need it.

This is actually a topic that I intend to cover in greater detail in a later article series but the realities of exercise are that most will not and can not burn a ton of calories during activity of any sort.  Under most conditions, 5 cal/min is pretty common (that’s 300 calories per hour) and values of 10 cal/min are sometimes achievable. Expecting much more than that is not realistic.

I’d note that bigger individuals burn more calories during activity by dint of being larger.  But their ability to do a lot of activity is usually quite limited.  Getting ahead of myself, I’ve seen people for whom, quite literally, 5 minutes continuous walking briskly on the treadmill had them fatigued.  That doesn’t provide much potential for calorie burn.

It’s a real catch-22.  And I’m Yossarian.

As I’ve written in several books, the contradiction is that the people who need to be able to burn a lot of calories in exercise (to skew energy balance) towards fat/weight loss usually can’t; their tolerance for exercise (either physically or psychologically) is simply too low.  And the folks who can burn a ton of calories in activity usually don’t need to.

In fact, many of the exercise studies done to date simply don’t support a massive impact of exercise on weight/fat loss, at least not in terms of the quantity lost (exercise certainly impacts on the quality of what’s lost; that is LBM vs. fat mass).  Sure a few have found an impact but tended to use fairly large amounts of activity (one that comes to mind threw people into 2 hours of moderate activity 6 days/week).  And spare me the interval studies; even the famous Tremblay interval study only saw a fat loss of a few pounds over 12 weeks.  That’s insignificant.

Now, this actually does have one huge practical implication that I’ll discuss in more detail in Part 3 and that is this: altering the diet has a much greater chance of drastically impacting on energy balance than activity in this population, especially in the beginning.  Because while increasing activity by 500 calories/day (assume 50-100 minutes of moderate-low intensity activity) is usually unrealistic, that same deficit can be created through diet much more easily.

And I’m not even talking about ‘going on a specific diet’ in this case; often simple qualitative changes to the diet can be made.  As an example, I had a client years ago who was drinking 4 or more full sodas per day.  I suggested he switch to diet soda (or water).  That change alone cut his calories intake by an easy 500+ calories day.  Result 1 pound+ fat loss per week with no real changes to his diet.  But I’m getting off track.

Back to exercise and its general irrelevancy in terms of significantly impacting energy balance.  Realistically, on average, exercise simply can’t and won’t have a massive effect.  Please note, there are other potential benefits to activity such as increased adherence, health benefits, etc.; burning calories is only one possible end-goal here.

But the bottom line is that, short of doing massive amounts of it, exercise is unlikely to have a massive impact on body weight or body composition.  And most untrained individuals (whether obese or not) are not capable of massive amounts of exercise.

This was actually apparently really big news last year (in Time magazine I think), the realization that moderate amounts of activity (say 30-40 minutes a few times per week) wouldn’t make you lose tons of weight.  Wait, this is news?  Hell, I wrote about this in The Ketogenic Diet nearly 15 years ago.

I guess the news is more in how exercise was either misrepresented (as a cure-all for everything) or misinterpreted (as a cure-all for everything).  The expectations were simply unrealistic; trainers and exercise biased folks either sent the wrong message or the general public heard the wrong thing.  And the bottom line is that most research does not find a major impact of realistic amounts of exercise on the quantity of weight loss.

However, most of those studies used not only fairly moderate amounts of activity, they also didn’t do anything in terms of progression. They simply gave the same moderate amount of activity throughout the length of the study without ever increasing anything.

Which brings me to a qualification of a statement I made above, that the beginning obese trainee usually doesn’t have much tolerance for activity (again, either in psychological or physiological terms).  And that qualification is to add the statement ‘at least not initially’ to the sentence.  But it can be improved over time.

In fact it always does improve and usually fairly quickly.  That’s one advantage of being untrained in anything, you see faster progress in most things, at least if the training is set up correctly. Which has its own set of benefits.  But the point is that, to some degree, the training should and must progress either in terms of volume (duration), frequency (times per week) or intensity (difficulty).  Or all three.  Again, this is a practical issue that I’ll get to in part 3.

In a final related vein, I’d point out, and this will sound like a gross overgeneralization (which it is) but most overweight individuals don’t particularly enjoy exercise in my experience.  It’s probably safer to say that most people don’t enjoy exercise, mind you; but this is a series about training the overweight beginner.  The reasons for this are assuredly multi-factorial and ultimately irrelevant.

Whether it was bad experiences as a kid (how many my age remember the horror of the President’s Physical Fitness test and the emotional scars it left) or simply the fact that exercise is not enjoyable (for reasons ranging from physical discomfort, to the realities of larger individuals moving vigorously, to the stress of being in a gym surrounded by buff assholes). This is yet another barrier to getting into a regular training program, on top of everything else I’ve discussed.  They don’t want to do it in the first place and, when they do, it doesn’t have a big effect.  Hardly a strong selling point.

And this fact (or at least gross overgeneralization) has a huge practical implication for training (relating to several psychological issues including affect, positive reinforcement and others) that I’m going to make you wait until Friday to read about in detail.  You can probably guess what they are (and what I’m going to suggest to address it) but you’ll have to wait in any case.  See you Friday.

Read Training the Obese Beginner: Part 3.

As usual, I’m going to be a bit long-winded so I’m going to divide this up into two parts.  Today I want to focus mainly on some of the underlying physiology that occurs in the obese (and make no mistake, what I want to cover won’t be anywhere close to comprehensive; I’ll focus on issues relevant to fat loss); next Tuesday I want to look at some practical issues that I find many forget when they give advice and/or train the obese hands-on.

Today, what I actually want to do is expand on a comment I made in Fasted Cardio and Fat Loss – Q&A which was this:

At the other extreme, that is in the very obese (here I’m talking about perhaps 35%+ body fat for men and 40%+ for women), the reverse problem is present.  There are tons of fatty acids floating around in the bloodstream, but for a variety of reasons, oxidation has become impaired.  To fully discuss this issue (along with approaches of fixing it) would require a full article and I won’t say much more about this group here.

While I could simply detail that, I feel that there are other issues worth discussing when looking at the training of the extremely obese and that’s what I’m going to do in this article series.

.Defining Some Terms

By extremely obese here, I’m primarily using body fat percentage as the determinant.  A male at 35%+ body fat and a female at 40%+ are in that category.   It’s possible to see even higher numbers; 50-60% isn’t unheard of at the real extremes of obesity.

I won’t mess around with BMI (for discussion of this see Measuring Body Composition Part 1) though it tends to be pretty accurate in this group.  That is, while they exist (usually heavier strength/power athletes taking steroids), you don’t see a lot of people at 300+ lbs body weight who aren’t carrying a lot of fat.

I’d also note that it is possible for relatively lighter individuals to carry quite a bit of body fat and much of what I’m going to discuss in terms of underlying physiological ‘defects’ will apply to that group.  But for individuals who are carrying both extra weight AND fat, there are issues (mainly issues of programming) that are critical to take into account.  I’ll cover those practical issues more in Part 2.

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So We are Very Clear

As one final pedantic note, so nobody takes me the wrong way, I used the term ‘defect’ above and will continue to use that throughout the article but I want to make it absolutely clear that I’m using it in its literal sense.  That is, many physiological systems become impaired (and whether or not this is a cause or a consequence of obesity is still up to debate) in obesity; that is they are defective relative to what is considered ‘normal’ physiology (normal being another loaded word).

But I am NOT using this to try to suggest any sort of negative fashion as if obesity is some sort of defective condition.  That is, the word ‘defect’ tends to have very negative connotations (in the same way that the literal meaning of ‘abnormal’ and the connotations that it carries are different) and I am absolutely NOT using the term in that sense.  Are we clear?  I’m using the term literally here, not connotatively.  And that is too a word.

Insulin Resistance/Syndrome X: Part 1

If there is a singular metabolic issue (and it’s really a cluster of issues) that tends to go hand in hand with obesity, it’s what used to be called Syndrome X and is now called the metabolic syndrome.  I’d note that while obesity tends to be one of the largest predisposing factors to development, it’s neither a guarantee nor a requirement.

That is, there is a proportion of people who despite being obese are metabolically ‘normal’ or ‘healthy’. It’s also possible to have elements of the Metabolic Syndrome (typically insulin resistance which is what I’ll focus on) and not be overweight.  But, with that said, on average, obesity tends to drastically increase the risk of developing the Metabolic Syndrome.

Now, the metabolic syndrome, as noted, is actually a cluster of different things including issues with dysregulated blood lipid levels, high blood pressure and a shedload of other things. I’m not going to focus on those since they don’t have much relevance to the main thrust of this article which is fat loss.  What I want to focus on is insulin resistance.

Now, insulin resistance, in rather simple terms, simply refers to a situation where various tissues in the body including skeletal muscle, liver and fat cells no longer respond appropriately to the signal sent by the hormone insulin.  This has a number of consequences not the least of which is that blood sugar levels tend to become dysregulated.

There is not only typically an increase in fasting blood sugar levels (which is actually diagnostic for the syndrome/pre diabetes) but some strange things can occur in response to the ingestion of carbohydrates.  Usually there is an overproduction of insulin in response to their consumption which can drive blood sugar too low and cause reactive hypoglycemia and/or hunger.

As well, because the liver is no longer responding appropriately to the signal sent by insulin, other bad things happen that I’m not going to detail here.  Of some importance, and I’d note that the causes of insulin resistance are very involved, is the fact that, when whole body insulin resistance develops, fat cells become resistant to the effects of insulin.  This has a couple of consequences one of which is that insulin no longer inhibits fatty acid release which is part of what I was alluding to in the section I quoted myself on above.

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Insulin Resistance: Part 2

That is, in normal physiology, in response to an increase in insulin levels (due to carbohydrate or protein consumption), the body will reduce fatty acid levels.  But in the obese, this pathway is inhibited (this is also part of why drugs that cause insulin resistance such as growth hormone, clenbuterol or ephedrine, often improve fat loss).  But insulin resistance at the fat cell is part of why there tend to be lots of fatty acids floating around in the bloodstream all the time.

This is actually part of what causes further insulin resistance (especially at skeletal muscle cells): chronically elevated blood fatty acids.  Of course, in that insulin is involved in fat storage, this also means that incoming calories no longer have anywhere to ‘go’ since insulin is no longer playing its storage role.  This is part of what leads to the increase in blood levels of glucose, fatty acids, etc. they can’t be stored where they belong.

In a very real sense, this is an adaptation to obesity that attempts to push calories away from fat cells (towards burning elsewhere). I’ve talked about in my books (especially The Ultimate Diet 2.0) that, in this sense, under certain conditions, being insulin resistant can be a ‘good’ thing.

This is especially true under both low-carbohydrate and low-calorie dieting.  If the fat cells are trying to keep calories out (and push them to burning elsewhere), this facilitates fat loss.  In this vein, one of the major adaptations to getting leaner is a massive increase in insulin sensitivity, which is part of what makes further fat mobilization more difficult as folks get leaner.

But going back to the obese, this adaptation is only beneficial IF other tissues are able to optimally burn those fatty acids off.  Which is what I’ll come back to next.

I’ll finish up this section by pointing out that insulin resistance has some practical implications in terms of the choice of diets.  Whether or not they have an actual ‘metabolic advantage’ in terms of fat loss, it’s become clear that reduced carbohydrate (and increased protein/fat) diets improve a variety of metabolic parameters associated with the metabolic syndrome.  This is even more the case if weight/fat loss occurs.

I’ll come back to this in part 2 and I’d refer readers to Insulin Sensitivity and Fat Loss on the site.  I’d also refer readers to Insulin Levels and Fat Loss – Q&A for more information about the issue of insulin and fat loss.  Moving on.

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RER, RQ, and NPRQ

No, not the talk-radio station.  First off, RER refers to respiratory exchange ratio, RQ to respiratory quotient and NPRQ to non-protein respiratory quotient.  All three refer to basically the same thing and I’ll use RER from here on out.  And what they refer to is the mix of fuel being used by the body both at rest and during activity.  I won’t bore you with the details, basically these three things are all a measure of the ratio of oxygen being consumed and carbon dioxide being produced and this is used as a proxy for fuel use in the body.

That is, biochemically we know that the burning of carbohydrates has an RER of 1.0 (1 molecule of O2 metabolized for each molecule of CO2).  The burning of fat has an RER of 0.7. Protein is somewhere in the middle (about 0.86 or so depending on the protein source).

So given that a whole bunch of conditions that I’m not going to bore you with are met (one critical one is steady state conditions so that means rest or aerobic activity, measuring RER during anaerobic activity is problematic), a measurement of RER tells you what the body is  using for fuel. I’d mention that since protein rarely contributes massively to fuel use in the body, protein is typically ignored.  That’s what NPRQ refers to: it’s the non-protein respiratory quotient. I’ll ignore protein here.

In any case, an RER of 0.7 would indicate 100% fat use, an RER of 1.0 would indicate 100% carb use.  Every value in-between those two extremes means a mix of fuels (lower equals more fat oxidation, higher more carb oxidation) and charts can be Googled if you care.  I’d note that some odd situations will cause an RER of below 0.7 to show up, it’s an oddity to do with carbon dioxide metabolism with ketogenic diets and you needn’t worry about it.

So what determines RER?  Well a bunch of things.  Gender (RER can change throughout the cycle), training status (more training tends to lower RER), and probably genetics all play a role.  Of some importance, habitual diet can affect things massively, in at least two ways.

As I discussed in Nutrient Intake, Nutrient Storage and Nutrient Oxidation and then expounded upon in How We Get Fat the body adjusts fuel use to intake; ignoring protein carbohydrate intake tends to influence things the most.  Eat more carbs and you burn more carbs and less fat (RER goes up).

As well, the status of muscle glycogen influences RER profoundly; high muscle glycogen tends to impair fat burning at the expense of carbohydrate oxidation.  That is, when muscle glycogen is perpetually raised, the body burns more carbs and burns less fat.   Keep this in mind when I talk about diet in Part 2.

So what’s my point?  Well, two points actually.  The first is that many studies have found that the obese have a higher resting RER on average; that is they tend to preferentially burn carbohydrates for fuel.  A study that just came out found that resting RER was predictive of RER during activity; that is folks who burn more carbs at rest burn more during exercise and vice-versa.

The second is that habitual diet (and a diet high in both carbohydrates and fats, and I’m talking about a diet that is, by definition, in excess of maintenance calories) can be a cause of further problems such as impaired fat burning and a preferential usage of carbohydrates.  Again, I’ll talk more about this in Part 2.

And this brings me in a roundabout way to my original quote from last Friday’s piece, the fact that the obese tend to have lots of fatty acids floating around but an impaired ability to burn them.  Which brings me to the next ‘defect’.

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Impaired Mitochondrial Function

A number of studies over the past years have found evidence of impaired mitochondrial function.  Now, for background, as everyone learned and promptly forgot in high-school science, mitochondria are specialized bits of the cell where things are burned, especially fatty acids.

There’s actually a fascinating history to how we gained the use of mitochondria that even I am not nerdy enough to detail here.  Oh yeah, I’d be remiss in not mentioning that the mitochondria are THE POWERHOUSE OF THE CELL (an in-joke for biochem nerds).

But study after study after study finds impaired function of mitochondria in both obesity and diabetes (I’d say more of the research has been done on the latter group) and this has a number of metabolic consequences not the least of which is impaired fat oxidation (some studies also find that the obese don’t increase fat oxidation during activity  as well as lean people; essentially they have lost a metabolic flexibility to switch between fuel sources).

Another consequence is that, because fatty acids can’t be burned in muscle cell (or liver) they are often deposited in inappropriate places or convert to things like ceramide that cause further problems.  But that’s getting a bit deeper than I want to go here.

Now a question that always raises its ugly head here is what’s causing what.  That is, does impaired mitochondrial function help to cause obesity, or does developing obesity cause the mitochondrial impairment?  You can replace those terms with just about anything else you want; there’s always a big question surrounding causation.

It can be a hard question to answer sometimes and there’s a third possibility that many tend to ignore: perhaps a sub-clinical mitochondrial impairment predisposes folks towards obesity and when that’s combined with the modern diet and lifestyle, as they become obese, the problem just gets worse.  Usually the truth is that third one for most of this stuff.

Usually this question is at least partially answered by seeing if weight loss and/or an increase in activity helps to reverse the ‘defect’.  In the case of most aspects of the metabolic syndrome, both exercise and frank weight loss tend to improve things. Note that improve is not necessarily the same as eliminate.

I would at least point people to the Biggest Loser Feedback for the improvements he saw in heart rate, blood pressure and blood glucose in a mere 14 days.  He got essentially normalization in a miniscule period of time secondary to a massive increase in activity and equally massive weight loss.

In the case of defective mitochondria, I can only think of one or two recent papers but the answer is that, yes, the ‘defect’ appears to go away with an increase in activity.  We have known for decades that one adaptation to regular aerobic activity is an increase in both mitochondrial number and activity and it would be strange that this would be unable to occur unless there were some massive pathophysiology occurring.

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Other Stuff

The above doesn’t even begin to scratch the surface of everything that’s going on in the obese individual but, as I said, I’m not trying to be comprehensive here.  I’d only mention a few other things before I move on, mainly as a setup for Tuesday’s application piece.

At least in terms of exercise per se, I have usually seen a few major issues that many trainers tend not to take into account.  The first is really specific to commercial gyms but I find that the very obese are often intimidated as hell going into the gym.  It can be tough surrounded by a bunch of skinny folks when you’re just getting started.  Ensuring a positive experience from the get-go is key; again I’ll come back to this in Part 2.  I’d note in this vein that studies show that having a positive experience from activity is a huge key in long-term adherence.  How surprising.

Additionally, the obese often have a very low tolerance for activity.  Sure, sure, you’ve watched the Biggest Loser and they jump them into hours of activity from the get-go.  And many have gotten various impact injuries from it.  One guy on BL Australia threw a clot as I recall, was limited to nothing but low volumes of low intensity activity afterwards.  Amusingly, he lost the most weight.  There might be a lesson there.

And make no mistake, they are going to kill someone with this silly bullshit.  I’ve seen it happen locally (the local Gold’s Gym killed a guy years ago by running him through intense activity right off the bat; he dropped dead of a heart attack), it will happen on prime-time tv, mark my word.  And when ratings soar….

But in general, without the incentive of $250k pushing them, the simple fact is that the obese often have a very low tolerance for any sort of activity.  If they get wrecked out of the gate, they are unlikely to even try exercising a second time.  In keeping with the idea of ‘ensuring a positive experience’, starting gradually and ramping up makes more sense then throwing than into the grinder.  The second approach may generate better short-term results but the long-term results are more at risk in my opinion.

Finally there are the simple realities of a larger individual moving their body during activity (both weights and cardio).  There are joint impact issues to consider, the realities of coordination that a 120 lb female personal trainer has no clue about, etc. This has implications for exercise choice and what can or should be done with the obese beginner.

And, again I’m sure I’ve left stuff out but between the look at physiological issues and the above, this is as good a place as any to stop for today.  I’ll talk about some practical application and lay out how I would (and in fact have) trained the extremely obese beginner based on this information.

Read Training the Obese Beginner: Part 2.

In that piece I answered a very specific question with a very specific answer.  I made no implications of anything beyond the exact answer I gave to that specific question.  And somehow people managed to read all kinds of asinine stuff into it, things that I never said or even began to imply.  It’d amaze me if I hadn’t seen people do this consistently over the past 15 years.

The basic confusion in that article was that folks interpreted my saying that carbs and protein can’t be converted to fat as ‘Lyle says you can’t get fat overeating carbs and protein’.  Which I absolutely didn’t say.  But people inferred, incorrectly.  Basically, what I said and what they heard were not the same thing.

I’d note before continuing that if folks had taken 30 seconds to click on and read the article I linked Nutrient Intake, Oxidation and Storage, they would have realized the mistake they were making as I specifically said that overeating carbs can still make you fat, just not through direct conversion (rather through indirect mechanisms).  But in addition to a lack of basic literacy, laziness seems to be endemic on the net as well.  And for not taking a couple of minutes to read the piece that I specifically linked to, a bunch of people got confused and then aggro.

I’d also note that if folks reading the protein piece had taken time to read the, I dunno, 200+ other articles on the site, they’d realize that I am making no such claim that you can eat all the carbs you want (or that lowcarb diets are superior, or whatever nonsensical conclusions they reached).  Or that one specific dietary approach (e.g. lowcarbs) is automatically superior to another.

But rather than do that, they took a single article, addressing a single specific question, and ran with it.  That’s not a good thing to do, you can’t take a single answer to a single specific question out of context and take that to represent what I believe. Well you can but it’s stupid to do so.  That’s what a lot of people did.

But since they couldn’t do any of that, couldn’t take the time to even read the single linked article much less the rest of what’s on the site, rather than writing about something more interesting today, I’m going to clear it up once and for all.  And I still expect someone to read this completely wrong and go around the Internet mis-representing what I’m saying.  I’m used to it at this point.

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How We Get Fat Part 1: Energy Intake Exceeds Energy Output

At a fundamental level, fat storage occurs when caloric intake exceeds caloric output, a topic I discussed in some detail in The Energy Balance Equation.  Now, I know that a lot of people claim that basic thermodynamics don’t hold for humans. Simply, they are wrong.  Invariably, the studies used to support this position are based on a faulty data set: to whit, they are drawing poor conclusions about what people SAY that they are eating.

For example, one popular book bases one of its many incorrect theses on a 1980 report suggesting that the obese ate the same number of calories as the lean.  Ergo, obesity was caused by something else.  The problem is this, the data set is wrong.  A fact we’ve known for nearly 30 years but that the author was somehow unable to become aware of in his ’5 years of dedicated research’.

Study after study after study over the past 30 years shows that the obese systematically under-report their food intake (by up to 30-50%) and over-report their activity (by about the same).  So when they say they are only eating 1800 calories per day, they may be eating 2400-3600 calories per day.  And their activity isn’t nearly what they think.

And when you put those same folks in controlled metabolic ward conditions and control their food intake and/or activity output…voila, the energy balance equation holds.  It’s only when you believe the (incorrect) self-reported data that it doesn’t.

And make no mistake I am NOT saying that the obese are lying about their intake, not consciously anyhow.  Most people simply suck at knowing how much they are actually eating.  Leave them to self-report it and they almost always screw it up.   If you’re mistaken enough to believe the self-reported values, you reach even more screwed up conclusions about things.

In that vein, I have found that the chronically underweight “I can’t gain weight no matter what I do” are invariably vastly over-estimating what they are eating.  That is, they are eating far less than they think.  Other studies show that ‘health conscious people’ tend to under-report their true ‘junk food’ and dietary fat intake; to appear more healthy they conveniently forget or leave out that trip to the burger joint.

Put differently, this isn’t something that only occurs in the obese (so spare me accusations of ‘hating the obese’ or some nonsense).  Am I clear or are people going to misinterpret me some more in the comments and claim I said that fat people lie about their food intake?  Because I’m not saying anything of the sort.  Make no mistake, I’m sure some do lie about it; most are just clueless about how much they are actually eating.

Now let me make it clear that there is obviously a lot more going on here, hormones and all manners of other stuff impact on the energy balance equation.  For example, chronically elevated cortisol does a lot of nasty things in terms of reducing metabolic rate (reducing the energy out side of the equation) as well as negatively impacting on calorie partitioning (where calories go when you eat them as discussed in Calorie Partitioning Part 1 and Part 2).  But for the most part, a lot of that is outside of our control.  It’s relevant but you can’t do much with most of it.  So I’ll focus on calories.

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How We Get Fat Part 2: Nutrient Intake, Oxidation and Storage Part Deux

The primary storage of fat in the body is in fat cells, duh.  Most of that is found in what is called subcutaneous fat, which is found under the skin.  There is also fat stored around the gut area called visceral fat (this surrounds the organs).  Fat can also be stored in ‘bad’ places like the liver and pancreas under certain conditions; this is called ectopic fat storage.

I’m going to focus here on subcutaneous fat.  There, whether or not fat is stored or removed comes down to a concept called fat balance, which I discuss in some detail in The Ultimate Diet 2.0.   You can think of fat balance as the fat specific equivalent of energy balance.  That is

Net Change in Fat Stores = Fat Stored – Fat Burned

I’d note that the same nutrient balance holds for protein, carbohydrates and alcohol (which I’m not going to talk about today).  That is, the net effect on bodily stores, whether protein or carbohydrate stores in the body increases, decreases or stays the same comes down to the balance of protein/carb stored vs. protein or carbs/burned.

So at a fundamental level, fat gain occurs when fat storage exceeds fat burning (technically oxidation).  And fat loss occurs when fat oxidation exceeds fat storage.  I’d note that both processes take place in some amounts throughout the day, controlled by a host of processes I’m not going to talk about.  Just recognize that what happens over time in terms of your fat stores comes down to the relationship between those two processes: fat storage – fat oxidation.

So what determines fat oxidation and fat storage rates?

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How We Get Fat Part 3: Back to Nutrient Intake, Oxidation and Storage

Now, here’s where people got confused by Excess Protein Intake and Fat Storage – Q&A, and where they would have been unconfused by clicking the linked article on Nutrient Intake, Oxidation and Storage.  In fact, I’d suggest you go read it right now, it’s not that long and since I’m not going to retype all of it here (that’s why I wrote it the first time), it’d be a good idea.  I’ll wait.

However, since I know most of you will have just ignored my suggestion to actually read that piece, I’m going to summarize a few points from it (as well as from the Q&A):

1. Carbs are rarely converted to fat and stored as such
2. When you eat more carbs you burn more carbs and less fat; eat less carbs and you burn less carbs and more fat
3. Protein is basically never going to be converted to fat and stored as such
4. When you eat more protein, you burn more protein (and by extension, less carbs and less fat); eat less protein and you burn less protein (and by extension, more carbs and more fat)
5. Ingested dietary fat is primarily stored, eating more of it doesn’t impact on fat oxidation to a significant degree

Let’s work through this backwards.  When you eat dietary fat, it’s primary fate is storage as its intake has very little impact on fat oxidation (and don’t ask me a bunch of questions about “But people say you have to eat fat to burn fat?” in the comments.  That idea is fundamentally wrong but would take an entire article to address).  It also doesn’t impact greatly on the oxidation of the protein or carbohydrates.

Carbohydrates are rarely converted to fat (a process called de novo lipogenesis) under normal dietary conditions. There are exceptions when this occurs.  One is with massive chronic overfeeding of carbs.  I’m talking 700-900 grams of carbs per day for multiple days.  Under those conditions, carbs max out glycogen stores, are in excess of total daily energy requirements and you see the conversion of carbohydrate to fat for storage.  But this is not a normal dietary situation for most people.

A few very stupid studies have shown that glucose INFUSION at levels of 1.5 total daily energy expenditure can cause DNL to occur but this is equally non-physiological.  There is also some evidence that DNL may be increased in individuals with hyperinsulinemia (often secondary to obesity).  There’s one final exception that I’ll use to finish this piece.

But when you eat more carbs, you burn more carbs and burn less fat.  And that’s why even if carbs aren’t directly converted to fat and stored as such, excess carbs can STILL MAKE YOU FAT.  Basically, by inhibiting fat oxidation, excess carbs cause you to store all the fat you’re eating without burning any of it off.  Did you get that?  Let me repeat it again.

Carbs don’t make you fat via direct conversion and storage to fat; but excess carbs can still make you fat by blunting out the normal daily fat oxidation so that all of the fat you’re eating is stored.  Which is why a 500 cal surplus of fat and a 500 cal surplus of carbs can both make you fat; they just do it for different reasons through different mechanisms.  The 500 calories of excess fat is simply stored; the excess 500 calories of carbs ensure that all the fat you’re eating is stored because carb oxidation goes up and fat oxidation goes down.  Got it?  If not, re-read this paragraph until it sinks in.

Oh yeah, the same holds for protein. Protein isn’t going to be converted to and stored as fat.  But eat excess protein and the body will burn more protein for energy (and less carbs and fat).  Which means that the other nutrients have to get stored.  Which means that excess protein can still make you fat, just not by direct conversion.  Rather, it does it by ensuring that the fat you’re eating gets stored.

Of course protein also has the highest thermic effect, more of the incoming calories are burned off.  So excess protein tends to have the least odds of making you fat under any conditions; but excess protein can make you fat.  Just not by direct conversion to fat; rather it’s indirectly by decreasing the oxidation of other nutrients.

Ok, is the above clear enough? Because I can’t really explain it any simpler but will try one last time using bullet points and an example.  Let’s assume someone is eating at exactly maintenance calories.  Neither gaining nor losing fat.  Here’s what happens with excess calories.  Assume that all three conditions represent identical increases in caloric intake, just from each of the different macros.  Here’s what happens mechanistically and why all three still make you fat:

1. Excess dietary fat is directly stored as fat
2. Excess dietary carbs increases carb oxidation, impairing fat oxidation; more of your daily fat intake is stored as fat
3. Excess dietary protein increases protein oxidation, impairing fat oxidation; more of your daily fat intake is stored as fat

Got it?  All three situations make you fat, just through different mechanisms.  Fat is directly stored and carbs and protein cause you to store the fat you’re eating by decreasing fat oxidation.

And I’d note again, since someone will invariably misread this that that doesn’t mean that a low-carb and/or low-protein diet is therefore superior for fat loss.  I’m not saying that and don’t think that I am.  Because in such a situation, while you may be burning more fat, you’re also eating more dietary fat.  So net fat balance can be unchanged despite the dicking around with macronutrient content.  It still comes down to the deficit.

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The Obvious Question: Why Not Just Eat Zero Dietary Fat?

And now I’ll answer the question that I know every person who has read (and hopefully understood) the above is asking: so if carbs and protein are rarely converted to and stored as fat, and make you fat by decreasing fat oxidation and causing all ingested dietary fat to get stored as fat, can’t I eat as much as I want of protein and carbs so long as my dietary fat intake is zero?

And the asnswer is still no.  Remember how I teased you above with one other exception, when carbs are converted to fat for storage?    That exception is when dietary fat is below about 10% of total daily calories.  Under that condition, the body ramps up de novo lipogenesis.  So you still get fat.

Because the body is usually smarter than we are.  Under conditions where dietary fat intake is ‘adequate’ (meaning 10% of total calories or more), the primary fate of that fat is storage and protein and carbs are used for other things.  And when dietary fat is too low, the body will start converting ingested carbs (and probably protein, though it would still be rare) to fat for storage.

Oh yeah, the other question you’re going to ask in the comments “What about alcohol?”  That’s going to require a full article so be patient.  I know that’s another thing lacking on the Internet but so be it.

And I really hope that clears things up.  If it doesn’t, read this piece and the linked articles until it is.

Now, I have a bit more clue what’s going on, or at least what I think is going on so I’m going to share one of these with you (I’ll address others in future articles).  Today I want to talk about something that I like to call the LTDFLE,  an acronym that I genuinely hope you will use at every possible chance on forums to confuse people, and which will make sense shortly.

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The LTDFLE

Anyone who has had the headache-inducing misfortune of reading (or trying to read) Supertraining by Mel Siff and Yuri Verkoshansky may have a clue where I’m going with this section heading.  In that book, one topic that is discussed rather endlessly is the long-term delayed training effect (LTDTE), a phenomenon whereby strength/performance gains often show up considerably (e.g. 2-4 weeks) after the heavy training has been done.  This can actually be explained fairly simply through a two-model fitness/fatigue theory of adaptation but I’m getting way off track.

LTDFLE stands for Long-Term Delayed Fat Loss Effect (I’d note that I have also seen a LTDGE which is a Long-Term Delayed Growth Effect but that’s another topic for another article).  Basically, this is the phenomenon whereby fat loss continues to occur even after the diet has been ended and/or calories have been raised back towards/to maintenance or even above.  In the same way that fitness sometimes continues to increase after the period of heavy loading, it’s almost as if there is some type of fat loss inertia whereby the diet continues working even after the person ends it.

Now, I talked about a similar phenomenon in the article Of Whooshes and Squishy Fat, a situation where, usually after the diet is broken (for a meal or a day), folks often wake up lighter and leaner.  But that’s more of an acute thing that I think can clearly be related to water retention/the release of such that happens when people break their diets (deliberately or otherwise).

The LTDFLE is a bit different and can last from 4-7 days (on average).  During that time, and note that this only happens after fairly prolonged dieting, as calories are brought up, people continue to get visibly and measurably leaner.  Skinfolds continue to drop, other measurements will continue to change in the direction of a decreased body fat.

I’ve observed the LTDFLE in myself, in trainees/clients and it’s something that a lot of bodybuilders (depending on how nuts they go) experience in the first few days after a show.  After all that work, after all that effort, they end up looking their best 2-3 days after the post-contest binge has started.

In fact, there’s actually even a weird study from back in the late-90′s that saw this although the researchers had no clue what was actually going on (because nutrition researchers don’t read enough basic science/endocrinology).  In it, folks were dieted hard for 4 weeks and then progressively refed (raising calories over the 5th week towards maintenance).  Body weight kept going down in Week 5 despite the gradually increasing calories (as I recall, they didn’t measure body composition).

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What’s Going On?

Now, it seems fairly obvious that at least some of the LTDFLE is due to water retention and water balances, just like the acute whooshes discussed in  Of Whooshes and Squishy Fat.  Although there is a great deal of variance, people often retain water (both under the skin and possibly within fat cells) when they are dieting hard and restricting calories and much of this is related to increases in the hormone cortisol (please note that water retention is profoundly more complicated than this).  Raising calories/carbohydrates and/or reducing training tends to shut down cortisol release.    Suddenly the body stops freaking out and water is dropped.  But I wouldn’t expect water loss to explain a full week of visual changes.  A day, maybe two, sure.  But not the 4-7 days that the LTDFLE typically runs.

An additional factor that is certainly involved, and especially with folks on low-carbohydrate diets who are doing a lot of training, is replenishing muscle glycogen.  As carbs are raised, the body starts sucking up carbs (this has an additional effect of pulling water into muscle which probably also accounts for water shifts), they fill out and start to look better.  This is assuredly a big part of why bodybuilders often look better 2 days after their show; instead of looking stringy and flat on stage, they get full and pumped.  If water is being dropped from the body at the same time, all the better from a visible standpoint.  Please note that muscle glycogen is only increased if the caloric increase comes from carbohdyrates; pigging out on high-fat fare won’t get it done.

Of course, the increase in glycogen/water mediated lean body mass will have a small effect on actual body fat percentage but, as discussed in Reducing Bodyfat by Gaining Muscle – Q&A, the effect is not large.  It doesn’t hurt, of course, but it certainly doesn’t explain all of it.

But even with that, it does seem that actual fat is still being lost, skinfolds get measurably smaller and people look leaner (and depending on what’s done next, often the skinfolds stay down suggesting that it’s more than just a transient water shift magic trick).  So beyond the above explanations, what’s really going on.   I suspect that at least some of it is related to leptin kinetics.  If you’re not familiar with leptin and what it does, I’d suggest you take the time to read the 6-part series on Bodyweight Regulation: Leptin. I’ll wait.

As I’ve discussed in my various books and in the article The Full Diet Break, leptin starts to increase fairly quickly when calories and carbohydrates are raised, even 5 hours of over-eating carbs can raise leptin.  With even a few days of eating more calories/carbs, leptin will go up.  And while many of the effects of leptin aren’t immediate (which is part of why I recommend 10-14 days for a full diet break), some of them might be.

Leptin is part of what regulates cortisol levels for example (leptin inhibits cortisol release) so at the very least, increasing leptin would help to reduce water retention. But some work has also shown a direct effect of leptin on fat cells in terms of lipolysis; leptin also promotes fat oxidation in skeletal muscle and elsewhere, perhaps the increase in leptin is directly stimulating actual fat loss.  Of course, that explanation is predicated on leptin going up/having a greater impact on things than the excess of calories coming in has on fat gain.

Related to that are thyroid hormone kinetics.  On a diet, conversion of the relatively inactive T4 to the more active T3 goes down in the liver and this rebounds fairly quickly when calories (and especially carbohydrates) are raised.  Tangentially, this is why I recommend a minimum of 100-150 grams of carbohydrates per day during a The Full Diet Break; that’s what is required to normalize T3 production in the liver. As well, leptin is involved in the control of thyroid stimulating hormone (TSH) so increasing leptin may also be driving thyroid output.

Now, T3 has both short-term and long-term effects on metabolism with most of the long-term effects being related to changes in gene expression; those take time to maximally occur (at least 14 days).  But T3 can also be degraded to T2 which has immediate metabolic effects on energy expenditure and it seems possible that increases in T3 and subsequent breakdown to T2 might be raising metabolic rate enough to not only offset the increased calories but also to generate extra fat loss.  That might explain part of the LTDFLE as well.

I mentioned gene expression above, this is just a nerd term referring to changes in which genes are turned ‘on’ or ‘off’ (simplistically speaking) in various cells.  And gene expression changes in response to dieting, caloric intake, activity, etc.  While some changes happen pretty quickly others take longer; it’s not an instantaneous process.  Many have observed that often a diet takes a solid week or so to start ‘working’ and this may be related to slower changes in gene expression when someone moves from an above maintenance caloric intake to a below maintenance caloric intake.

And the same may be working in reverse, the body is still effectively in a ‘fat burning mode’ for some period of time after calories are raised.  Along with any direct effects of leptin and/or thyroid on lipolysis/fat oxidation/metabolic rate and the shifts in water balance, the situation is still simply this: people often keep getting leaner in the first week off their diet (again, this assumes that they don’t go totally nuts with food intake).

I’d note in this regards that my own Ultimate Diet 2.0 actually takes advantage of this to get a short-term sidestep of the energy balance equation: for about 24 hours following the 4 hard days of dieting/glycogen depletion, even in the face of massive carbohydrate intake, the body preferentially stores the incoming carbs as glycogen while using fatty acids for fuel (part of why fat intake has to be kept low during the carb-load).  Folks may be at literally double maintenance caloric intake and still be losing fat.  Magic?  No, just good science.  Ok, maybe a little magic.

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Summing Up

And that’s the oddity that is the LTDFLE: that magic period where, despite raising calories, you keep leaning out and losing fat.  It’s only about 7 days at the longest and can be shorter if people go really nuts with their food intake.  This is especially true if a lot of high-fat foods are consumed for extended periods.  Empirically, making the LTDFLE work the best seems to involve raising carbohydrate intake moreso than dietary fat.  In that vein, in the short-term 2-3 days), leptin levels are only responsive to increasing dietary carbohydrate intake, not fat.

So that’s the LTDFLE, an oddity of fat loss that tends to occur after fairly prolonged dieting when calories are raised.  It’s not universal and doesn’t always happen but when it does, enjoy it. Before I finish, let me make one thing very clear which is that the LTDFLE only occurs after fairly prolonged actual dieting (which can still contain free meals and refeeds as discussed in A Guide to Flexible Dieting).  Don’t think that you’re going to get the magic effect of the LTDFLE by half-assing it for a couple of weeks and then raising calories and voila.

In a future article, I’ll look at another specific oddity of fat loss, the situation where combining a large caloric deficit with too much activity can actually hurt rather than help weight/fat loss.  But that’s for another day.