Tackling obesity

Fat men and his personal trainer with a megaphoneTackling obesity is a very hot topic nowadays; however recommendations from specialists remain a bit confusing. Which kind of exercises is better? Aerobic (e.g. long run) or resistance (e.g. weight lifting)? Should some restriction in food consumption be implemented? Has weight loss intervention to be rapid and aggressive or slow and smooth?

Here I give my personal opinion on topic, which is based on some theoretical knowledge (though I am not claiming to be an expert in nutrition), and on my practical coaching experience.

Before start talking on this issue, I would like to make clear that, for simplicity reason in this article:

-i am not going to discuss surgical interventions to reduce fat deposits;

-i am not going to discuss any dietary methods for “deceiving” our body (make you feel fuller with the lesser calories);

-i am not taking into account that everybody has different characteristics of metabolism; so the same amount of calories consumed and the same activities may have a result in dissimilar energy balance for a different person.

Identifying the problem

First of all, it is necessary to define the overweighting. There are some “norms”, which describe a relation between a body weight and a body size, and if this relation tends to be higher, a person can be considered as overweight or, even, ( if ratio is really high) obese. This is measured by BMI (body mass index), which represents simply weight in kilos divided by squared height in meters. So in fitness literature, a person who has BMI more than 25 is considered as overweight, whereas a value of 30 could be called obesity. It is simply like that. Life is however more complicated. One problem is that we can gain weight through the muscle mass, which is generally good for ordinary people (not always for athletes), or through the fat mass which is bad. Another problem is that our body constitution is different as well. You may be short and wide or tall and slim. BMI does not take into account this stuff. So it doesn’t reflect a real situation with overweighting: have you excessive fat or not. A short , muscular, six-packs-press person may be considered as overweight, whereas tall one with a beer-belly – underweight.

Before start to design a weight losing programme it is necessary to understand what exactly you are not happy with: with your weight or with an amount of fat in your body?

Of course, the last one is more common. Sometimes, however, too much muscle mass may be a problem as well. For example, footballer, who gains excessive muscle mass (especially at his upper body), may become less agile and too “heavy” for rapid movements with the change of direction, though his body fat percentage is pretty normal. In this case, we can say that he needs to lose weight. Another person (non-athlete) may have normal weight, but an amount of fat in his body composition is over norm, whereas muscle mass is less. This person should lose fat and gain muscles.

To make our intervention more precise, we need to know; do we have excessive fat or not? There are some methods to help. Skinfolds measurements are designed to calculate person’s body fat percentage. Whereas they are relatively strong for measuring subcutaneous fat, they can “miss” visceral fat, so a person who’s fat concentrates mainly in visceral region ( has a big belly), but not under his/her skin, can be mistakenly considered as normal. In opposite, measuring hip-waist ratio, which is targeting belly region, we can “miss” other excessive fat deposits.

Bio-impedance devices (e.g. scales) give relatively good estimation about average person. They, however, are vulnerable to morphological deviations, the differences  in the electrical properties of the skin, and can be influenced by food and water consumption.

Other methods, such as: underwater weighting, DXA scan and MRI are mostly for scientific laboratories, and are not suitable for everyday life.

Though none method alone can give us the exact information about our body composition, however, in my opinion, using combination of above mentioned methods is possible for the achievements of general understanding of person’s body composition and dynamic of its changes.

Negative energy balance

So let’s take usual situation, when a person wants to get rid of the fat and save or even increase muscle mass. Often, people want to lose fat from particular region of the body (e.g. belly or hips). Nevertheless, it is necessary to note that , though, there is not complete agreement between professionals about a possibility to tackle particular areas of the excessive fat disposition, however, body of literature consider that it is impossible. So we cannot, for example, reduce beer-belly just by doing crunches. The region, from which fat will be taken first, is defined by the fat type and genes. The main determining factor for changing body weight is energy balance.

Energy balance is the difference between calories consumption (or rather utilisation) from the food and calories expenditure for body functioning and activities. It can be positive (more come than spend), negative (less come than spend), and neutral (equal amount come and spend).

In my opinion, the only (non-surgical) way to lose fat is to create a negative calorie’s balance.

It means that the amount of calories intake should be less than their expenditure, and the body starts to spend fat reserves to cover daily needs. This looks very simple. But to lose even 3-4 kilos is not so easy in reality. Let’s see why.

We can change balance from the two sides:

1. Decreasing calories consumption

2. Increasing physical activity

Each approach has its advantage and limitations. Let’s start with the calories restriction.

Advantage here is that with the fasting you will lose weight relatively rapidly. General male adult spends around 2000-2400 kcal per day. One gram of fat gives us 9 kcal theoretically and probably around somewhat less kcal in reality. So, for one day of fasting, a person may lose around 300 grams of fat, which is a huge amount. However a long term fasting put our body under serious physical and psychological stress, when vital cognitive and physiological functions can be deteriorated. In addition, we will lose muscle mass together with the fat and that is, probably, not what we wanted. Losing will be slower than expected, because even in short term fasting, humans are very “unwillingly” spending calories, when available amount is not enough for basic functions. With the help of hormones, they switch to “emergency mode” and restrict spending on other functions, such as physical activity and heat production. Then person, who was fasting, uses first opportunity to restore calories deficit. Very often, after few days of fasting or “sitting” on restricting diet, one gives up and gain back what he/she has lost, even with some extra kilos.

In terms of exercise, luckily for our survival but unluckily for weight loss, we are very economical creatures. To spend the same 2000 kcal, we have to run around 25 kilometers that is definitely impossible for an ordinary person. It is important to be gradually accustomed to the physical workload. In addition, exercise is time consuming. Good thing about exercise is that it allows creating negative energy balance without cutting food consumption bellow basic metabolic level (what our body needs for maintaining necessary functions). This is physiologically and psychologically healthier and easier.

The best strategy is to tackle overweight from both sides. We need to review a person’s diet trying, while not going bellow basic metabolic needs, to find out whether we may get rid of some “unnecessary” calories. Secondly, we have to gradually increase our level of physical activity. Both these things aim to create negative energy balance, which is ultimately the only way to lose weight.

Why it is so difficult?

The main reason is that, as I already mentioned, a person most likely is not accustomed to aerobic exercise with significant energy expenditure. In simple words, he/she is not ready for long running. Sometimes, serious overweight (obese) person is just not able to run due to muscle-skeletal and joints problems. In this case, trainer has to find other aerobic activities like walking, cycling, swimming, etc. These are however less energy demanding. Even more difficult is to achieve significant calories loss with the strength exercises. Though they can be very intense and exhaustive, overall energy demand is not sufficiently high.

Another problem is that doing exercise we cannot just substitute fat with the muscles. When we are losing body weight with the exercise, we are losing mostly fat, however muscle mass  decreasing as well. This is due to a negative energy balance cannot provide enough materials to rebuild muscles. Muscle mass is one of the variables which contributes to the strength, so some deterioration in force production (especially absolute strength) is possible. In opposite, if we gain muscle mass with the help of the strength programme and a diet, we will add some fat as well, because energy balance is positive and some excess from building muscles goes to the fat reserves.

Six possible variants

With the two changeable variables: an energy balance (negative, neutral and positive) and a level of physical activity ( low and high), there are six variants of the long-term changes in person’s physical conditions, body weight and composition:

1. Energy balance – negative, level of physical activity –low. This means that the negative balance is created due to dietary restrictions. Long term consequences:

Body weight-down, Fat – down, Fat percent probably down, but not so significant, because he/she loses muscle mass as well. Physical conditions – down, general well-being – down as well (though adepts of low calories diet will be not agree). Person loses his beer-belly (fat), but becomes weaker.

2. Energy balance – neutral , level of physical activity – low. Body weight would be the same, amount and percentage of fat gradually – up, muscle mass – gradually down. In simple words he/she gradually decrepitates.

3. Energy balance – positive, level of physical activity – low. It means excessive food intake. No need to talk a lot about what will happen next. This will be obesity.

4. Energy balance is negative; level of physical activity is high. Person will start to lose body weight, mostly fat but some muscle’s mass as well. However, due to sufficient physical activity, his/her muscles, though not getting bigger,  will get a good tonus. If the energy consumption does not fall below the basic metabolic level, person will be in a good mental and physical shape.

5. Energy balance is neutral, level of activity – high. Probably this is most arguable variant. Can body composition be changed without changes in weight? Can fat be substituted with the muscle mass? In my opinion, generally, the answer is no, though some minor changes are possible. In this scenario body weight will be the same, muscle mass to fat ratio generally the same. Though person’s physical conditions and wellbeing will go up, he/she probably won’t get rid of the belly (hips, etc.).

6. Energy balance is positive, level of activity – high. A person becomes stronger and bigger, due to increase in his/her muscles and (though to less extend) in fat. Unfortunately a belly won’t disappear.

Practical examples

Let me take two examples from my practice.

“Ordinary” client

Male 44 , height 172, weight 75 . So, as we can see, his BMI (25.35) looked pretty normal. Fat percentage, calculated through skinfolds measurement, was at the high border of the norm (24.5%). However, he had excessive fat deposits in his belly region (waist to hip ratio: 1.05 whereas norm is less than 0.94). Aerobic fitness was low, a strength needed some improvement as well.

Taking into consideration all these variants and client’s initial conditions, we have chosen following strategy:

1. Stage one: preparation.

Volume- moderate with the low intensity.

The aim of this stage was to accustom client to a physical exercise. Though main target was an aerobic fitness, general strength training was given as well, as it was necessary for successful implementation of the aerobic exercises, injury prevention and for the creation basis for further strength development. Duration of this stage was six month with trainings three times a week.

2. Stage two: weight loss.

Volume- high with the moderate intensity.

At this stage we created negative energy balance with the high level of physical activity (variant 4 ). This was created mainly due to increasing volume of aerobic exercise (running, swimming, and bike). Some minor adjustment in a diet was made, however calorie consumption remained generally at the norm (2000 kcal per day), and client’s mood and general wellbeing were satisfactory. Duration was 4 month with trainings three times a week. During this stage, he has lost 5 kilos and his belly has gone.

3. Stage 3: Body’s rebuilding.

Volume- moderate with the moderate to high intensity

The last stage was devoted to the creation of the new body composition. We created positive energy balance by decreasing volume of aerobic exercises. At the same time, we increased exercise intensity and amount of strength exercises within hypertrophy range. My client has gained 2 kilos, mainly due to the increasing muscle mass. He has become stronger and aerobically fitter. Stage 3 has taken two month.

So the whole programme has taken one year. Was it too long? I don’t think so. To lose a belly wasn’t the only aim. The main target was to make him fitter and to change his life style. Belly’s loss was the logical consequence of these positive changes. If I applied changes too quickly, perhaps I would be have “broken” my client.

High level sport

Here is another example from my high-performance training practice, when I used generally the same strategy but in its concentrated form.

Professional kick-boxer had an offer to fight for the Russia Champion title in 67 kg category. The fight had to have place in 5 weeks. At the starting point his body weight was 77 kg, with the excess of the upper body muscle mass because of the excessive passion to the body-building exercises.

The aims of physical preparation were defined as: losing 10 kilos, increasing in special endurance, and increasing of the speed of punches.

Differently from the first case, athlete had been already accustomed to the serious workload and needed just relatively short period of general physical conditioning for a preparation to the high-intensity specific training. We  used these two weeks of a preparation stage for losing most of excessive weight as well as  getting rid of excessive muscle mass in upper body region, which made him slower. Training programme included a lot of running exercises with specific training for losing muscles on upper body. Some adjustment was made in a diet. Sportsman has lost 7 kilos in two weeks and, though it cannot be said that we could completely avoid some deterioration in his strength and mood, generally, his conditions were satisfactory. In the second two weeks period the work was more specific and intense, however, volume was lower and negativity of energy balance was minimal. Though the trainings were very hard, athlete was already accustomed to the training regime and a diet. He lost 2 kilos, however felt himself stronger, “lighter” and quicker. Last week was devoted to tapering with the almost neutral energy balance, which was maintained through the tactical training, short high- intensity specific exercises and sport games. We  got rid of the last excessive kilo, that wasn’t difficult. He had won that fight after 5-ht round, when his opponent couldn’t cope with the high tempo and was completely exhausted. The fight had been won mainly due to the excellent physical conditioning, in spite of the fact that losing significant weight in boxing  often followed by decreasing in strength and endurance. In this case, however,  it had been done mainly at the first stage and did not spread out to the whole preparation period. Sportsman  had enough time to build up his “new” physical conditions, while remaining in a good mood and health.

after champion fight

After the fight: I had lost 5 kilos myself.

Conclusions

1. For losing weight, whether it is fat or muscle mass, you have to create negative energy balance. It is more rapid to do so through the food restriction than through exercise, however, fasting is a risky way. Revise your diet and increase physical activity.

2. How rapidly and safely you can lose weight depends on how much you need to lose relatively to your initial condition and your ability to perform long aerobic exercises.

3. We are able to gain muscles in a particular region (e.g. hips), but it is difficult to lose fat only in the particular region. It means, that if we want to correct a specific part of our body ( to lose fat and gain muscles there), we need to lose fat in whole body, and then to create new shape in the region of interest with the special strength programme.

4. Every type of exercise is useful for weight loss; however, long aerobic workouts are more effective for spending calories.