Training the Obese Beginner: Part 2
Last Friday, in Training the Obese Beginner: Part 1 I took an apparently somewhat complex look at some of the physiological ‘defects’ that are often seen with the development of obesity. This included a look at insulin resistance/the Metabolic Syndrome, resting and exercise fuel use, and the issue of impaired mitochondrial function. I also finished with a sort of grab-bag of other issues including a general low tolerance for activity along with a couple of psychological issues and others. Hell, just go read Part 1 again (or for the first time), it’ll be faster than this awful summary.
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.
Great article Lyle. I missed the BL feedback until today.
This wasn’t mentioned, and it is what really ticked me off the first time I saw BL – They take 100+ lbs overweight individuals, and have them run. I’m curious how many need knee replacements now.
I got lazy a few years ago and added 50lbs of fat to my 6’2″ frame. The day I decided to stop making excuses, I dusted off my running shoes and started down the street. I made it one block before my knees were on fire, and I had no previous injuries to them. 5 years later, and the damage I did to them in one block is still there – I can’t run now without severe pain.
I figure these impact injuries must be happening on the BL, and their edited out of footage, and silenced in the contracts – your thoughts Lyle?
Great article, Lyle, but hardly surprising. I actually think the BL does so much more harm than good to the general population in terms of ridiculous information.
So, when can we expect that article on alcohol?
Lyle,
How would one diagnose an underlying leptin deficiency? Is this determined through a blood test or can one ascertain such a condition through observation alone?
Thanks.
Jon
“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.”
A certain Scottish trainer on the West Coast apparently refuses to get this memo. Ditto for the comments about the Tremblay Study.
Thanks as always for your detailed coverage, Lyle. It’s too bad that there aren’t more excellent “obsessive compulsive completists” out there these days!
“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. “
As you say, diet will create the fat loss, and exercise is a relatively small contribution. So the exercise supervised by a trainer should be for things other than fat loss. As you say,
“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.”
The “other potential benefits” are often the reason the trainer selects predominantly weight training for their client, it’s not simply a meathead’s love of the iron.
Anyway, what can a trainer offer a client in a session? Most cardio activities are a bad idea for obese beginners. Firstly because of the injury risk – 150kg going through someone’s knees ain’t good, and intervals could quite literally kill them. People can cycle and swim, of course, but let’s face it, those activities will never be as popular as the treadmill or stepper.
Secondly because when we’re talking exercise supervised by a trainer, most people don’t need supervision to walk on a treadmill. Higher intensity or interval training needs supervision, but as you note, the obese beginner shouldn’t be doing that. The trainer can assign low and moderate intensity cardio activities for non-supervised sessions, give the trainee a pedometer and ask them to do 1,000 more steps each week, that sort of thing.
If not cardio, and intervals are too dangerous for most obese beginners, then what are we left with for a trainer to offer during supervised sessions? Weight training.
As well, the obese beginner will typically have various muscle imbalances from the same lifestyle that gave them the obesity, weak back and legs from sitting at a desk at work then sitting on the couch at home, that sort of thing. Thus tight upper traps, rounded shoulders and back pain. They’ll also have low self-esteem, feel inadequate in the gym. Weight training helps with these issues, as will flexibility training (which will be part of any competent trainer’s sessions anyway).
Consistency is the most important aspect of physique change. Most people give up in the first months. They give up because they’re not seeing any change. But change of course is slow. So we need things which are going to encourage them to keep going – some progress. My experience is that people aren’t very impressed by their progress on the treadmill. “I used to walk 6km/hr with a heart rate of 120bpm, now I can walk 8km/hr with 120bpm. So what?” But they’re impressed by progress with weights. “When I started I couldn’t press even the bar, now I can press 40kg, I can lift my kid over my head!”
So it’s not necessarily ideas about EPOC and the like that are determining the trainers’ preference for progressive resistance training. Those other paranthetical issues (to be covered in a later 7-part series) are often quite important.
Finally a general comment:- not every topic needs a 7-part series. I think you’ve spent too many years arguing with people on the internet, you sit there writing and thinking that someone is going to say, “if” and “but” and you try to cut them off with endless qualifications of what you’re saying. But you know the iffers and butters are not going to read the article properly anyway, so it’s wasted effort. Keep it snappy.
Well, gee whiz, Kyle, where to start?
First off, it’s tough for me to take ‘keep it snappy’ seriously when you wrote an essay. As I keep repeating to folks: if you don’t like my site and how I write then don’t read it. But don’t whine about me being thorough when you voluntarily come here.
Beyond that, hows about your wait for part 3 to see what I recommend rather than making a bunch of dumb inferences about what I’m going to suggest from a practical training perspective? Probably better than what you did above.
Lyle, keep up the tangents. I love them.
Lyle, thank you for all of these great articles, but aren’t you afraid Cosgrove is just going to steal more of your work?
Lyle,
I just wanted to add that I think people often underestimate your training knowledge or pigeonhole you as a nutrition expert only (that is if being considered an expert in an area can constitute truly being pigeonholed), but I find that to do you a gross disservice. Your mix of extensive analysis and practicality is a welcomed escape from the typical BS that gets spread around. And personally I enjoy the fact that you so often qualify things and expound on issues, because it reminds us all that while simple is usually a good thing, that doesn’t mean that context and nuance get tossed aside in favor of appealing to the lowest common denominator.
I personally like all the qualifications and conditions you make for all your comments to make sure they are precise. Sure beats broad generalizations or misleading ‘snappy’ comments.
Jesus. Keep it snappy? Are you serious? Go read someone else’s blog, Kyle. At the end of every one of Lyle’s articles I’m wishing there were more there. Consider the possibility that you have a limited attention span/ability to comprehend complex subjects and move on.
I love reading your blog Lyle. It’s always a snap back to reality. There’s so much bullsh*t out there and it’s always so refreshing to come back here and ‘pull focus’ so to speak. I’m an exercise science student and feel like I know what’s what, but there’s so much crap out there you start to question what you think you know.
Cheers.
Agree with Frankie. Just love this. Thank you lyle
Lyle,
I love the length. Keep it up; you take the time to explain everything and I don’t care how long the articles are, I read every single one of them.
This, as I am taking it, gives more reason to believe that you cannot out train a bad diet. And Lyle, I believe that you should know, as you approach both nutrition and training from a scientific standpoint with experience behind it. Keep up the good work. I’m going to keep on reading!
Juile: Pretty much. Unless you can do just an absolute enormous amount of activity, you can always overwhelm most any caloric deficit with a poor diet. Making changes to, or at least, controlling diet to some degree, has to be part and parcel of any effective at loss program. This is yet another topic I want to look at in some detail at a later date. Just a reality check on what exercise can and can’t do.
This is a great series!
It sounds like I might be doing OKAY then because I’m 350lbs (5’11”/21 years old) and I only walk a few hours a week and put most of my focus on fat loss by creating a calorie deficit. I see tremendous improvements in my ability to just move around, which is great, but my diet really has been the key. I’ve lost over 30lbs since March by focusing on my diet and meanwhile only walking an hour or so a few times a week.
One of the reasons I can’t do as much physical activity is because I have a curve in my tibia (along with a leg length discrepancy of about 1 1/2 inches) as well as the dreaded meniscus tear. I increase my activity as I lose more, but primarily I focus on monitoring my calories.
Fantastic article. This site has really been a great aid to me as I work towards my goal of losing 100lbs so that I can get an osteotomy.
Hi Lyle, you were in God’s mind for all eternity for this time and place ,among other things , to lead the crowd swayed by unceasing bullshit (what’s the point of masking that “i” with an * anyway?) to the promised land of sound nutrition and physiology (for lack of a better catch-all term)knowledge, or a wonderful product of evolution, whichever explanation suits you. You stay away from “The one thing THEY don’t want you to know”, “The one simple secret to losing tons of fat while sitting on your fat ass” , and all sorts of clichés and worn-out expressions, and that is VERY refreshing. You’re one hell of a smart guy and an awesome writer. I love getting the straight facts, so keep on being obsessive-compulsive about “useless physiology minutae”. Thanks for what you do.