Miscommunicating The Science of Weight Management

Somewhere we’ve gone wrong in communicating the strong and indisputable scientific evidence that exercise plays an important role in weight management. As a consequence many people with obesity are confused and frustrated with the less than expected weight loss achieved when they begin to exercise. The media-hype has contributed to this confusion. Sensational headlines can relay an inaccurate message that exercise is not helpful (or healthful). To make matters worse some scientists even disagree on the role of exercise. In their controversial editorial published in the British Journal of Sports Medicine (Br J Sports Med 2015;49:15 968-969), the authors conclude that “It is time to wind back the harms caused by the junk food industry’s public relations machinery. Let us bust the myth of physical inactivity and obesity. You cannot outrun a bad diet”. The editorial and sensational media coverage has set back progress in the practice of weight management.

Make no mistake, there is no myth involving the important role of exercise in weight management. The partial truth is that on average exercise alone does not promote much weight loss. This is sometimes surprising even to scientists. Expending a large number of calories during exercise can be difficult for individuals with obesity and low fitness levels. Some compensate for exercise by becoming more sedentary and/or eating more during the remainder of the day following exercise. The bottom line is that a reduction in calories consumed is needed for most individuals to lose a meaningful amount of weight. Suffice it to mention that any diet that reduces calories, is adequate in nutrients, doesn’t require a dramatic exclusion of fat, protein or carbohydrate, and can be adhered to will probably work just fine.

So, why is exercise important in weight management? The most important reason for anyone to exercise is to reduce the risk of chronic diseases and to improve mental and physical health. Obesity is associated with an increased the risk for chronic diseases, reduced quality of life, and reduced life expectancy.   Exercise has a favorable impact on all of these and more. In addition, exercise reduces the risk of weight gain and avoiding further weight gain and mitigating comorbidities such as diabetes and cardiovascular disease should be the first goal of any sound weight management program. Importantly, exercise also reduces the risk of gaining weight after weight loss.

Weight loss is a short-term strategy that involves expending more calories than consumed. A goal of 5-10% weight loss within 6-12 months is achievable for most and is a level associated with improvements in many of the health problems associated with obesity. More ambitious goals are possible but also more challenging to achieve. Engaging the help and advice of healthcare professionals should contribute to individual success.

Weight management is a lifestyle, one that involves an ongoing use of behavioral change strategies (e.g., daily weighing) that are helpful in maintaining weight.  Those who are most successful at maintaining weight loss over time rely on a number of behavioral strategies such as reported by participants in the National Weight Control Registry (www. nwcr.ws/research), the largest prospective investigation of long-term successful weight loss maintenance. The registry is composed of individuals who have lost 30 to 300 pounds and maintained their weight loss for 1 to 66 years. Among a multitude of positive health behaviors common to these individuals, most exercise daily for an average of an hour per day and consume a low fat, low calorie diet. Over half of these individuals lost weight with the help of some type of program. Many commercial weight loss programs such as Jenny Craig and Weight Watchers have been shown to be helpful. The most prudent approach to weight loss and weight management, particularly for those with health problems accompanying excess weight, should involve consultation with a qualified healthcare provider with training and experience in weight management.

More effective communication on the science of exercise and weight management is needed. Several elements should be considered. Scientists need to be precise and objective when discussing their work. The differences between weight loss and weight management is more than semantic in nature. Healthcare professionals need to be clear with short-term goals for weight loss and longer-term goals for weight maintenance. The goals should be reasonable and easily distinguished. The importance of healthy eating and exercise as part of a lifestyle approach should be emphasized. Of course, the media also has a responsibility in maintaining the delicate balance between writing eye catching sciences stories and accurately delineating what is known and not known. Finally, the consumer needs to be critical of all sources of information particularly when the sources is other than healthcare providers with the qualifications, training and experience in weight management.

The Life of a Scientist

“In science, there is always an experiment to be performed, an unexpected result to troubleshoot, a poster to prepare, a conference to attend, newly published research to read, old research to brush up on, a minus 80 to de-ice, primers to borrow, a protocol to overhaul, a technician to train, a bench to disinfect, equipment to order, reagents to prepare, glassware to clean, and malfunctioning computers to turn off and on again.”

Quoted from an article that was indicating which professions consume the most coffee. By the way, research scientists were number one.


Find the whole article here.



AMA Recognizes Obesity as a Disease

The American Medial Association, the nation’s largest physician group, has officially recognized obesity as a disease. This declaration could cause physicians to take greater care in treating those with the disease as well as inspire insurance companies to reconsider paying for weight loss treatments.

This decision was controversial for several reasons. One of the main concerns was that BMI is used to diagnose the disease, a measurement the article called “simplistic and flawed.” Concurrently, the AMA has no legal authority and further, there is not a universal agreement of what constitutes a disease in the first place.

One of the best comparisons stated in the article was: “the suggestion that obesity is not a disease but rather a consequence of a chosen lifestyle exemplified by overeating and/or inactivity is equivalent to suggesting that lung cancer is not a disease because it was brought about by individual choice to smoke cigarettes.”

Find the article here: http://www.nytimes.com/2013/06/19/business/ama-recognizes-obesity-as-a-disease.html?_r=0


“(De)Personalized Medicine”

Personalized medicine uses a patient’s genetic information to help determine the best type of treatment for them. This sounds promising, however in many cases environmental factors dominate genetic factors.  For example, traditional cardiovascular disease risk factors are better predictors of disease than genetic factors.  In a recent issue of Science, Horwitz et al, argue that it is essential to integrate clinical, social, and environmental data with the individualized genomic and molecular information when treating a patient in order to provide the best care.

The implications of a genomics-based to “personalized” medical treatment are considerable.  For example, treatment of native American Pima Indians (who are at high genetic risk of diabetes but have a low indicence of disease) would result in exaggerated risk assessment and overtreatment. The authors suggest that personalized treatment would be “equally inappropriate” for present day Pima Indians consuming a Western diet, due to the importance of “gene-environment interactions.”

What are your thoughts?


Horwitz, R.I., et al., Medicine. (De)personalized medicine. Science, 2013. 339(6124): p. 1155-6.

Translational Obesity Research Conference at Virginia Tech

Virginia Tech invites you to participate in our first biennial obesity conference entitled “How can translational research solve the obesity epidemic?” 

When: June 17-18, 2013

Where: Blacksburg, VA

Speakers from Louisiana State University, Wake Forest University, and Harvard University will be attending.

Registration is now open. For more information, visit:


What plays a larger role in obesity? Genetics or Economic Conditions?

Over the past thirty years, the cost of fattening foods has decreased while the rates of obesity have heightened. It has been found that both genetics and the environment can have an effect on obesity, but which plays a larger role?

Dr. George Davis from the Department of Agricultural and Applied Economics and Dr. Deborah Good from the Department of Human Nutrition, Foods and Exercise have joined forces to investigate this problem.

The investigators concluded that cost of food — rather than one’s genetic makeup — is a major factor in the decisions that lead to eating high fat foods.

“People get the impression that if something is in their genes, there is nothing they can do about it,” Davis said. “This gives us hope that people who are predisposed to certain types of behavior can overcome those impulses by using economic incentives.”

Read the full articles here:

VT News Article: Economic conditions may trump genetics when battling obesity

Published Manuscript: Effects of Incentives and Genetics on Food Choices and Weight Phenotypes in the Neuroendocrine Gene Tubby Mutant Mice