exercise – Direct Medical Care

The New Year often brings renewed commitment to weight loss or healthier choices.

I spend a lot of my time as a physician counseling patients on how to approach weight loss.

What is the key to successful weight management? It truly is simple. You need to have a calorie deficit. A calorie deficit is when your daily calories burned are greater than your calories consumed.

The difficulty is that the number of calories burned in a day is so variable from person to person. We each have what is called our basal metabolic rate which is the amount of calories our body uses just sitting around. A 200 pound muscular male may have a basal metabolic rate of 3000 calories per day while a 200 pound obese male may have a basal metabolic rate of 1200 calories per day. Comparing diet plans to your neighbor should never be done. Discovering the calorie deficit for you as an individual to successfully lose weight is the key.

I had a discussion with a registered dietician/personal trainer about a client who was gaining weight despite her great efforts in the gym. She had her on an 1800 calorie a day diet. I pointed out that her basal metabolic rate is probably too low to allow for 1800 calories. If she is working out one hour in the gym and burning 600 calories during that time and her basal metabolic rate is 1000 calories, she will gain weight. The proof was in her lack of weight loss, but she went ahead and pursued VO2 max testing. This test evaluates oxygen consumption at rest and estimates your basal metabolic rate. I was not surprised when her results came back at 800 calories per day.

There are always questions about tools to help with weight loss. Yes, there are many things that can be used to help aid in weight loss, but they are only tools to help you do the fundamentals. We all know individuals that have had success with surgery or medicine only to regain the weight and more. If you use the aids to help you eat good food in appropriate portions, you will have success. When surgery or medicine is used as the solution rather than the aid, failure is likely.

I am a runner and have learned fundamentally that it takes time and energy, methodically putting one foot in front of the other. I have tools to help make the process easier—good supportive running shoes, inspiring music, and an app on my phone to tell me good job as I go. The truth is I still have to run. Weight loss is the same. You still have to do the fundamentals—remember calorie deficit.

So what should a good diet plan focus on other than the number of calories? Real food and not processed food which includes fruits, veggies, lean meats, and dairy. This should be the mainstay of your diet.

Poor diet choices cannot be compensated for by hours in the gym—the math just won’t add up for an appropriate calorie deficit. Exercise is good and necessary for a healthy lifestyle, but it is not the key to good weight management.

Ann Riggs, DO

Patient-Driven Affordable Healthcare