MI Take

I am joined by Dr Eric Trexler for a deep dive into  some of the reasons why we struggle to lose weight even when we increase our physical activity and how our bodies evolved to constrain our overall energy expenditure. 

Here are the core themes of the discussion:

Constrained Energy Expenditure Model:

• Dr. Eric Trexler explains the constrained energy model, which shows that even with high levels of physical activity, total energy expenditure doesn’t increase indefinitely. This model is seen in both highly sedentary and physically active populations.

Energy Compensation in Weight Loss:

• The conversation dives into how the body adapts during calorie restriction and high activity levels, compensating by reducing energy expenditure in other areas. This compensation occurs in both structured exercise scenarios and everyday physical activities like walking.

Metabolic Adaptation and Efficiency:

• Metabolic adaptation, including improved mechanical efficiency and hormonal changes, helps the body manage energy during high activity with low energy intake. This is seen in athletes and populations like hunter-gatherers, where even extreme activity doesn’t lead to excessive calorie expenditure.

Exercise and Appetite Regulation:

• Exercise not only impacts energy expenditure but also plays a critical role in regulating appetite. Physically active individuals generally have better control over their hunger, which aligns their energy intake more closely with their energy needs.

Exercise in Weight Loss Programs:

• While exercise alone may not cause significant weight loss, it’s essential for long-term weight management. Exercise helps maintain fat-free mass, improves appetite regulation, and enhances overall well-being, making it a key component of successful weight loss strategies.

Limitations of Exercise in Driving Weight Loss:

• The constrained energy expenditure model suggests that the effectiveness of exercise in driving weight loss is less than one might expect. However, exercise is still beneficial when combined with dietary changes, as it supports better long-term outcomes by maintaining muscle mass and promoting healthier habits.

The Role of Non-Exercise Activity Thermogenesis (NEAT):

• A substantial focus is on NEAT, which encompasses all physical activities outside of formal exercise. Maintaining step counts or general activity levels is seen as crucial for preventing metabolic slowdowns during weight loss, though there are inevitable declines in energy efficiency.

Physiological Limits to Energy Expenditure:

• The human body has a practical and possibly physiological ceiling for sustained energy expenditure, generally 2.5 times an individual's basal metabolic rate (BMR). This limit is seen in both elite athletes and everyday scenarios, such as pregnancy.

Exercise’s Broader Benefits:

• Beyond weight loss, exercise has a range of health benefits, including improved mental health outcomes, such as reduced depression and anxiety, better cardiovascular health, and enhanced sleep quality. The importance of clustering healthy behaviors, such as regular exercise, good sleep, and better food choices, is emphasized.

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[0:00] - Introduction

[0:43] - Effect of Weight Loss on Diabetes Remission

[5:13] - Trends in Sugar and Non-Sugar Sweetener Intake

[14:53] - The Reasons People Struggle to Gain Muscle

[23:15] - Being "Balanced" is a Lie

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[0:00] - Introduction

[0:43] - Is Exercise Useless for Weight Loss

[15:38] - Ultra Processed Foods

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[0:00] - Intro

[0:42] - Fish Oil and Heart Disease

[5:53] - BREAKING NEWS! COFFEE SAVES YOUR BRAIN!

[9:30] - The Built Environment and Obesity

• Prevalence Map
• Food Intake Map
• Physical Activity Map

[16:38] - Coaching is About Being the Best Version of Yourself

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[0:00] - Introduction

[0:40] - Tests of Energy Balance

[1:12] - Energy Manipulation and Direction and Magnitude of Weight Loss/Gain

[1:48] - Bortz 1968 paper

[2:41] - Bouchard et al. 1990 Paper

[4:23] - Direct Manipulations of Dietary Factors

[9:38] - Covert Energy Losses and Energy Balance (SGLT paper 1 and 2)

[12:58] - Patience and Consistency

Stubbs and Prentice Citations

Stubbs R J, Prentice A M (1993). The effect of covertly manipulating the dietary fat:carbohydrate ratio of isoenergetically dense diets on ad lib intake in 'free- living' humans. Proceedings ofthe Nutrition Society 52: 341A.

Stubbs R J, Murgatroyd P R, Goldberg G R, Prentice A M (1993a). The effect of covert manipulation of dietary fat and energy density on ad libitum food intake in humans. Proceedings of the Nutrition Society 52: 35A.

Stubbs RJ, Ritz P, Coward W A, Prentice A M (1993b). The effect of covert manipulation of dietary fat and energy density on ad libitum food intake in 'free-living' humans. Proceedings of the Nutrition Society 52: 348A.

Stubbs R J, Harbron C G, Murgatroyd P R, Prentice A M (1995a). Covert manipulation of dietary fat and energy density: effect on substrate flux and food intake in men feeding ad libitum. American Journal ofClinical Nutrition 62:
316-329.

Stubbs R J, Ritz P, Coward W A, Prentice A M (1995b). Covert manipulation of the
dietary fat to carbohydrate ratio and energy density: effect on food intake and energy balance in free-living men, feeding ad libitum. American Journal ofClini- cal Nutrition 62: 330-332.

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[0:00] Introduction

[0:40] - Diet Archetypes

[3:27] - The Efficacy of Different Diets and Diet Archetypes

[7:25] - How Diets Work

[17:00] - Why Diets Work Until They Stop Working

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