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What is the Best Exercise for Weight Loss? Medical Minute #22

What is the Best Exercise for Weight Loss?

Hi, I’m Dr. Craig Primack. Today I’m here to answer the question, “What is the best exercise for weight loss?”

I’m going to answer that question. But first we have to talk about exercise in general. When you enter a weight loss program, we believe about 80% of your weight loss comes from diet and 20% from exercise, but that 20% is important.

If you’re missing 20% of anything, you surely aren’t getting all the benefit that you can get. In a second, I’m going to turn to our whiteboard and talk to you about a study that came out in the early 2000s in the Annals of Internal Medicine.

 The Walking Study

I am back. So behind me is a graph of the study we’re going to talk about today. This is an exercise study. It was a study done on walkers. There’s two things to know about it before we even get into it.

Number one, the walkers were asked to not diet. If you’re eating healthy, keep eating healthy. If you’re eating lousy, keep eating lousy for the duration of the study.

And that’s the second part. The duration of the study was eight months. Just walking in the study is not the fastest way to lose weight without diet or without any other interventions, so we had to do it for eight months. Let me show you the graph.

I’m here… There’s two axes. There’s the vertical axis, which is what their weight did. At the end of the eight months, whether it was up, whether it was at zero, whether it was down… And we’re going to go through each of those points. And across what we call the X axis… 6 miles, 12 miles or 18 miles a week on average.

If we start right here, the person who falls on this dot right here was not exercising and did not diet. So their distance was zero and they gained 2.2 pounds. Now over eight months, that’s not a lot of weight. But if you put eight months together, plus eight months, plus eight months, we do see a lot of weight gain. Not surprising.

Six, 12 or 18 Miles a Week

If someone was able to do six miles per week, they crossed the distance at six and their weight at zero. So the people were able to do six miles a week walking, maintained their weight, or at least didn’t lose or gain weight. Now, the neat thing about the six miles is, it doesn’t matter how you get there. You can walk one mile, six days in a row. You can walk three miles twice a week, or two miles three days a week.

If you were to say, “Six is great, but I want to do a little more.” If you get up to 12 miles in a week, now we’ve lost 2.2 pounds. Again, not a lot, but we are going in the right direction. Then you go from 12 to 18. 18 miles in a week, and now we triple our weight loss from 2.2 to 6.6 pounds. Now we’re starting to see something. But again, remember, none of these people added diet in there.

So I have another line I’m going to add. I’m going to dash this line. This line wasn’t part of this study, but we’ve read a lot of studies so far. We’re going to call this one the Diet Line. I’m going to call this one the No Diet Line.

If someone starts a diet, but does no exercise, here they’re losing just under 2.2 pounds on average. Then if you get to six miles in a week, the person who was losing nothing not on a diet, now adds a diet and they’re actually doing pretty well.

If you double it and you go to 12 miles in a week, that person’s actually doing even better. And as you can guess, the person doing 18 miles is doing the best. So really the take home point of this, I think, is that everybody should start with diet. Everywhere along the diet line, whether you’re doing no exercise or a fair amount of exercise… And really remember, 18 miles a week, we walk at an average of three miles per hour. So there’s one hour per day, six days a week. The person doing six miles does a little more, and so forth.

So the take home message is such. Number one, you should start with diet. Because everywhere along the Diet Line, people are losing weight. Then once you’ve started to diet, the more exercise you’re able to do, the more weight you’ll lose.

 The Answer

So now going back to the beginning question that I had. So the answer to the question, “What is the best exercise for weight loss?”, is not a trick answer. But the answer is, “The one that you like.”

Exercise is a big help in weight loss, as we’ve just seen. But if you hate the activity that you’re doing, you’re going to look, unfortunately, for every excuse in the book to not do it. In Arizona when it’s hot out, it’s too hot. When it’s dark out, it’s too dark. When it’s cold out, it’s too cold. As opposed to the other, which is I’m looking for an excuse to do it.

I have a meeting tomorrow that’s going to last from 8:00 in the morning to 5:00 in the afternoon. So maybe I’ll wake up a little bit early and get my walk in or my run in, or get on my Peloton. Whatever your favorite exercise is. And it really doesn’t matter. The more you like it, the more you’re apt to do it.

And the more you hate it, the more every minute you’ll be saying to yourself, whether this is conscious or subconscious, “I’m going to burn 300 calories and I’m going to go eat 300 calories worth of food. The pain of this exercise, I need the pleasure of something that’s off my plan that’s a cheat quote/ unquote food.”

The One You Like

So in the end of the day, find an exercise you like or exercises that you like. I personally like a variety of them. And then do them on a regular, very regular basis.

Thanks, and I’ll see you next week.h


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