Instead of picking a lane, I'd like to bring up what's good and bad about both sides. In doing so, I'll probably piss off literally everyone in the wellness space because the expectation is to pick a side and vehemently defend it. But then again, my jam is evidence-based practice. And both conflicting ideologies are conveniently ignoring evidence that doesn't support their dogmatic messaging.

Here's the gist of the whole "debate" in a nutshell from the two extremes:
Diet Culture: "Carrying extra body fat is always bad for your health. Being fat is 100% a choice. All diets (that create a calorie deficit) work if you stick to them."
Anti-Diet Culture: "Carrying extra body fat is never bad for your health. Being fat is 100% determined by things outside of choice (genetics, social determinants of health, environment). Diets don't work."

So, who's right? Both. And neither one. The truth is somewhere in the middle, as is often the case.

I know people on either side will feel like this is an attack, but the evidence is clear that excess body weight CAN be harmful to health in terms of predisposing towards illness and early death AND excess body weight CAN also be harmless in that it's not tied to negative outcomes for the individual. Both are true. It turns out that health is multifaceted.

In this post, I'll attempt to shore up the main arguments from both sides that are actually supported by evidence:

First off, the claim that excess body fat = "unhealthy" or poor health outcomes:

Obesity is strongly correlated with elevated risk of chronic health conditions such as heart disease, type 2 diabetes, hypertension, cancer, sleep apnea and other respiratory issues. Obesity is also associated with decreased life expectancy.

Studies related to poor health outcomes/decreased longevity linked to obesity:

• Hu FB. Obesity and mortality: watch your waist, not just your weight. Arch Intern Med. 2007;167(9):875-876.
• Guh DP, Zhang W, Bansback N, et al. The incidence of co-morbidities related to obesity and overweight: a systematic review and meta-analysis. BMC Public Health. 2009;9:88.
• Bhaskaran K, Douglas I, Forbes H, et al. Body-mass index and risk of 22 specific cancers: a population-based cohort study of 5·24 million UK adults. Lancet. 2014;384(9945):755-765.
• Yusuf S, Hawken S, Ounpuu S, et al. Obesity and the risk of myocardial infarction in 27,000 participants from 52 countries: a case-control study. Lancet. 2005;366(9497):1640-1649.
• Gami AS, Caples SM, Somers VK. Obesity and obstructive sleep apnea. Endocrinol Metab Clin North Am. 2003;32(4):869-894.
• Peeters A, Barendregt JJ, Willekens F, et al. Obesity in adulthood and its consequences for life expectancy: a life-table analysis. Ann Intern Med. 2003;138(1):24-32.
  
• Caleyachetty R, Thomas GN, Toulis KA, et al. Metabolically healthy obese and incident cardiovascular disease events among 3.5 million men and women. J Am Coll Cardiol. 2017;70(12):1429-1437.

What all of this data points to is that obesity can negatively impact quality of life and longevity, and what many of these studies illustrate is that the highest levels of obesity are the most impactful on health outcomes.

On the flip-side: Let's look at the anti-diet claim that obesity has NO impact on health. I couldn't find much evidence that obesity has absolutely no impact on health... but, there is evidence that excess weight can be protective in some subsets of the population. This data is highly subject to specific scenarios and does not have the preponderance of data across subsets that the other argument (obesity is usually unhealthy on average) has. 

• Lavie CJ, De Schutter A, Milani RV. Healthy obese versus unhealthy lean: the obesity paradox. Nat Rev Endocrinol. 2015;11(1):55-62.
• Oreopoulos A, Padwal R, Kalantar-Zadeh K, et al. Body mass index and mortality in heart failure: a meta-analysis. Am Heart J. 2008;156(1):13-22.

There are what's known as "metabolically healthy" obese individuals who don't have the markers of metabolic syndrome that we often see in obesity. But, so far, there doesn't seem to be evidence that these metabolically healthy obese individuals will be protected long-term from the associated risks of obesity over a lifespan.

• Kramer CK, Zinman B, Retnakaran R. Are metabolically healthy overweight and obesity benign conditions?: A systematic review and meta-analysis. Ann Intern Med. 2013;159(11):758-769.
• Eckel N, Meidtner K, Kalle-Uhlmann T, Stefan N, Schulze MB. Metabolically healthy obesity and cardiovascular events: a systematic review and meta-analysis. Eur J Prev Cardiol. 2016;23(9):956-966.

I think a much stronger claim from the Anti-Diet side of things would be: the act of dieting is, itself, injurious to an individual's health. Many studies have examined the harm of dieting on mental and physical health. This is, as always, an "it depends" scenario where dieting can be undertaken without negative health outcomes by some individuals and where dieting can be associated with poor health outcomes in others.

Dieting appears to be particularly harmful to health in yo-yo dieting/weight cycling individuals who are repeatedly gaining and losing weight.

• Montani JP, Schutz Y, Dulloo AG. Dieting and weight cycling as risk factors for cardiometabolic diseases: who is really at risk? Obes Rev. 2015;16 Suppl 1:7-18.
  
• Dombrowski SU, Knittle K, Avenell A, Araújo-Soares V, Sniehotta FF. Long term maintenance of weight loss with non-surgical interventions in obese adults: systematic review and meta-analyses of randomised controlled trials. BMJ. 2014;348:g2646.

Dieting can also be correlated with nutritional deficits and negative and even disordered behaviors and eating patterns when individuals engage in very restrictive eating patterns:

• Gabel K, Hoddy KK, Haggerty N, et al. Effects of 8-hour time restricted feeding on body weight and metabolic disease risk factors in obese adults: A pilot study. Nutr Healthy Aging. 2018;4(4):345-353.
• Madden AM, Mulrooney HM, Shah S. Estimation of energy expenditure using prediction equations in overweight and obese adults: a systematic review. J Hum Nutr Diet. 2016;29(4):458-476.
  
• Neumark-Sztainer D, Wall M, Guo J, Story M, Haines J, Eisenberg M. Obesity, disordered eating, and eating disorders in a longitudinal study of adolescents: how do dieters fare 5 years later? J Am Diet Assoc. 2006;106(4):559-568.
  
• Lowe MR, Thomas JG. Measures of restrained eating. In: Allison DB, Baskin ML, eds. Handbook of Assessment Methods for Eating Behaviors and Weight-Related Problems: Measures, Theory, and Research. SAGE Publications; 2009:121-161.

So, at the end of the day, when you look at the totality of all of this data (not just the side you most strongly agree with), it turns out that excess weight CAN be harmful to health and dieting CAN be helpful. But, also, excess weight CAN be benign or even protective and dieting CAN be harmful to health. It depends on individual circumstances.

I don't think I "like" anything from diet culture, but I guess what I like from general fitness culture is the emphasis on working with your body to try to improve your own health and wellness outcomes. My problem with diet/fitness culture is that it often misses the nuance of how each person's individual journey is a unique scenario. I like what the anti-diet crowd has brought to the table in terms of shining a light on individual differences and the natural spectrum of variety of bodies. I also like that we are now having a conversation about the negative impact of dieting on health. For many individuals, a healthier path may not involve dieting - even in individuals who are overweight and obese.

Wherever you fall on the continuum, I hope that you keep in mind the following:
Healthy lifestyle changes need not result in weight loss. Sometimes they do, sometimes they don't. There are things you can do that will improve your health like increasing your step count, engaging in weight lifting, adding some cardiovascular exercise, eating a variety of foods that meet your nutritional needs and so on. These things can improve health with or without weight loss. If you care about your health or the health of your clients - why not shift the focus towards that instead? Seems like a win-win!

​- Julie

A thought for today: what is the simplest path for you to get that result you want?

Let's say the result is physique change (just guessing that's why you're here). You want to either lose fat or gain muscle. Or maybe you want a combo of both. So, what's the is the simplest path? Let's really boil it down. You may think it's incredibly complicated. Maybe XYZ fitness influencer that you want to look like has convinced you that it's super-duper complicated and only they know some miraculous method that no-one else knows that will make all your dreams come true. They are lying to you. To get your money. Sorry, not sorry. They need you to believe that they have some secret knowledge. The reality is, it's not that complicated.

Fat loss is simple. Muscle building is simple. I think you know that, deep down.

You don't need a new workout program or a new diet. But, that's what you're seeking because you think that maybe you just haven't found the right "trick" yet. I'm here to tell you what I wish someone had told me when I started my own journey in 2017: there is no trick or hack. You already know what you need to do!

To lose weight: You need to eat less calories. How much less? Well, enough to move the needle, in other words, enough to create a calorie deficit. You can do this in a variety of ways. In the news this past week, a celebrity lost 100 lbs in 40 days by not eating (he reports that he did it by using a so-called "water fast" - only drinking water, no food). He didn't enter "starvation mode", because that doesn't exist. He just lost weight because that is what always happens when you consume signicantly less calories over time. Obviously, this is a pretty extreme example. You don't need to fast to lose weight, it's just one of many different strategies that get a person into a calorie deficit. A more realistic approach for many people is just reducing daily calorie consumption by a percentage from what you eat to maintain your current weight. You could try reducing daily calories by, say, 15-25% and see how your body responds to that and then adjust. The hard part here is getting really really really honest with yourself. For example, if you are trying to lose weight, it's helpful to track your food to see what you are currently consuming and then reducing from there. If you are averse to tracking, you will need to follow some sort of a diet/plan. We humans are all pretty bad at "guessing" how much we are eating, so this is an opportunity to get honest with yourself and start paying attention.

To build muscle: You need to follow a progressive overload training program. This means that you are lifting weight in a way where you are challenging yourself to increase difficulty over time. It's methodical and requires you to push yourself. There's no hack or shortcut to growing muscle.

I doubt any of this is new information. But, you may be feeling stuck at the point of: okay, but what do I do specifically? I need a program to follow for training and eating.

Enter AI! This is where many people believe that an "expert" is needed. I disagree. I think that there has never been a better time to set up your own training and eating towards your specific goals. Obviously, the internet has been around for quite a while now and you could always do some digging to find books and articles about optimal training splits, nutrition, and so on. But, the new thing that large language models like ChatGPT are bringing to the table today in 2023 is a really easy interface where you can directly ask a question about personalized training/nutrition and get immediate answers that leverage all of that lovely information on the internet that you previously had to painstakingly comb through manually.

So, you want to set up a general hypertrophy training program and diet plan for free? Let me show you how you can do it yourself today with the free version of ChatGPT:

First:
Go to: https://chat.openai.com/
Create a free account/log in.

Here's 2 prompt paths (one for training, one for nutrition):

Training prompt idea:
"Create an optimal full-body progressive overload gym training plan for with ___ 1-hour gym sessions per week."

Notes: I'd fill in the blank with whatever number of training sessions you think you can reasonably commit to each week, consistently.
You'll get a very reasonable response and you can print that out or copy it into a training app or journal to bring with you to each session.
You can further customize your training plan from here by asking ChatGPT to refine your program to include only exercises using (for instance) dumbbells (if that's what you have at home). You can also customize your program around physical limitations you may have etc. This is how you can use a free service to get really dialed-in advice.

Nutrition prompt idea:
"Calculate the daily calories to create a calorie deficit for a ___ year old __(gender)____ who weighs ____ lbs, lifts ___ days per week, gets ___K steps per day, and want to lose ____ lbs in ___ weeks."

From this prompt (customized with your information), you will get a really nice, simple explanation of BMR, TDEE, and what a daily kcal amount might look like that would produce a calorie deficit and should produce weight loss. If your goal was muscle gain, you would optimally create a calorie surplus (in which case, you'd specify "create a small/moderate calorie surplus" in the prompt above, depending on your goal).

From here, daily macros:
"Create a sample macro split using ____ kcal/day that includes at least ___ G protein per day."
Here you can fill in whatever your protein goal may be. General rule of thumb is to aim for around .8-1 g/lb of bodyweight. If you are very heavy, such a high protein goal can be difficult to achieve, so sometimes people use .8-1 g/lb of their goal bodyweight instead of their current/starting bodyweight.
This will generate a daily macro plan for you allotting a percentage of your daily kcals to protein, carbs, and fat. If you are used to tracking macros or want to adapt from here, you can just take those numbers and follow them by tracking your food in a macro tracking app like MyFitnessPal (which has a free version).

From daily macros, a meal plan:
"Using the macros you just generated, come up with a daily meal plan."
From here, you'll get a sample meal plan that you can follow. You can also customize the meal plan with prompts like this:
"Using the macros you just generated, come up with a daily meal plan with 4 meals."
"Using the macros you just generated, come up with a daily meal plan that's vegetarian."

And so on. You can keep customizing this by adding and removing meals, ingredients and so on to whatever your dietary needs and preferences are.

I hope this is helpful. I know a lot of people struggle with nutrition and exercise and it can feel like it's so complicated that you'll never figure it out. I wanted to show you how to utilize new AI tools to build yourself a no-cost plan. I do think there is value in hiring a coach, even with so much free information out there. But, not everyone can afford coaching and many just aren't ready for that level of financial commitment at this point in their lives. I don't want to be the kind of coach that hoards information. My goal is to be helpful. Always. 

What I (or any good coach) can offer you is guidance and accountability. Once you realize that a lack of information was never the problem, you'll start to notice where the real resistance is. It's not about a lack of knowledge... it's about the difficulties of consistently executing, even and especially when you don't feel like it. Because whatever changes you need to make to move closer to your goals, there will be internal resistance. We humans are creatures that resist change and gravitate towards our established habits and patterns. Old patterns are worn in our brains like footpaths through a forest. Setting up new patterns is hard work. But it is possible.

I believe that changing your life is always an option. That will mean different things to different people. I certainly don't think this only applies to fitness. We are the ones in the driver's seat of our own lives. There will sometimes be factors you cannot predict or control. It will sometimes feel like the world is against you and that others have it easier, but that's just noise. Control what you can control. In other words: do what you can with what you have. 

As Gandalf so wisely says to Frodo, "All we have to decide is what to do with the time that is given us.” - J.R.R. Tolkien, The Fellowship of the Ring.

Wishing you good health.

- Julie

Sounds too good to be true right?

Well, it might be. I've noticed that many fitness influencers preach this method for weight loss. Basically, they coach clients on how to create a calorie deficit eating "the same foods you eat now". I feel like this is fairly obvious, but the only way one can actually do this in practice is to eat significantly less of the same foods. So, yes, you could use this strategy, but it will mean slashing your portions of those foods.

Is that a potentially helpful weight loss strategy? Eat the same foods - cut down the portions. Yes! Of course. The problem that I see many clients rubbing up against in this scenario is that people pursuing weight loss may have already established habits of overeating highly palatable, non-satiating foods. If this is you, I'm not confident that you attempting to eat, say, 20% or 25% less of exactly the same foods is going to be very sustainable.

Let's just try this out as hypothetical exercise. I will list some of my favorite foods that I used to eat a lot of while I was living in an obese body (defined by BMI, diagnosed by my health care providers - no I don't love the term "obese", but it's currently the accepted medical term).  So, while I was obese, I would eat a very high calorie breakfast. I didn't realize it at the time, but looking back, I can see what happened. I would sometimes eat a giant bowl of cereal or granola or I would make a homemade breakfast sandwich if I was eating at home. If I was eating out, I might get a restaurant breakfast sandwich or a meal which consisted of eggs, bacon, bread, pancakes, etc. I'd often combine this food (which was probably somewhere in the 700-1500 kcal range) with a 200-400 kcal "coffee". By that I mean a latte or chai tea with milk and sugar etc.  So, I was usually looking at somewhere around 1000 kcals in one meal. And the rest of my meals (lunch and dinner) would usually be calorically similar. I would get *some* protein in (maybe an egg or a little meat, maybe some milk), but it wasn't much proportionately compared to the amount of carbs and fat that I was consuming. I'd throw butter on everything willy-nilly and if I ever were to track food or do a diet recall, I wouldn't have even considered "counting" butter or oil that I cooked in or that my food was prepared in.

So... if I were to continue to eat like that, but wanted to create a calorie deficit to get to the weight I am today (going from 200 lbs to 135-140 lbs), I'd probably have to slash those calories in half. It's worth noting that I was continuing to gain weight while I was consuming somewhere around 3000 kcal/day, so this was not me eating at maintenance - it was an (unintentional) surplus.

Let's say I decided to slash my 3000 kcal per day lifestyle down to a 1500 kcal per day lifestyle (not recommending this - just halving everything for ease of comparison). That would mean eating half an egg sandwich in the morning with a half a coffee. Maybe half a meat sandwich with half a bag of chips for lunch. Half a pasta bowl for dinner, and so on. None of the meals I regularly ate were very satisfying. So, I'd imagine that if I had tried this strategy out for a few days, I would have ended up ravenously hungry. Because, even though I was overeating and gaining weight, I wasn't feeling stuffed with even this very large (calorically speaking) amount of food. 

Everyone has a different set of circumstances, so I really don't know if this has been your experience or if you have had a totally different experience. What I do know is that sustainable fat loss over time is hard. Ridiculously hard. And one of the reasons it's hard is that we are often able to lose weight temporarily, but we often go back to old habits and ways of eating after the diet "is over." There needs to be a plan for maintaining a lower weight after weight loss.

And that plan needs to include a means of eating less food and still being satisfied. People who feel hungry all the time and never feel satisfied are pretty unlikely to keep themselves in a constant state of hunger forever. Add to that hormonal imbalances, medication side-effects, lifestyle stressors etc. that impact hunger and satiety and you can see why most weight loss attempts are unsuccessful in that they end in weight regain.

So, what can we do?

One strategy, and this is the strategy I use, is to completely change your way of eating to support staying full longer. This is not easy, but if you're able to choose more satiating foods, you may find it easier and more comfortable to sustain a calorie deficit during a weight loss phase AND to sustain maintaining your new (smaller) body after weight loss. Remember that a smaller body takes less kcals to run. This means that you'll need to continue eating less long after a weight loss phase is over. A note of caution here though - this does not mean that you'll need to eat at your deficit/diet calories forever. You should be able to increase your calories after a weight loss period ends. Using a TDEE calorie calculator can give you a good ballpark, but you'll really only know what your exact new maintenance calorie range is by trial and error. It's going to be highly individual and highly related to factors like how much you move - those who move more (especially NEAT) will require more kcal and those who move less will require less and so on.

How can you stay as full and satisfied as possible while consuming less total calories?
Add in more:
1. Protein
2. Fiber
3. Veggies (well, these are usually full of fiber too!)

Try out a bunch of foods and see how they make you feel. We all have different preferences, needs, cultural foods, etc. See if there are foods that you actually enjoy that can help you increase protein and fiber in your diet because these foods will really help if you are struggling with a deficit or even at maintenance and find yourself hungry. Obviously, some amount of hunger is pretty typical during weight loss, but building your meals around a solid foundation of protein and veggies can really help!

Here are a few simple ideas:
Protein + Carb + Fat
chicken + rice + cheese
tofu + stir fry veggies + oil
yogurt + fruit + nut butter
eggs + toast + butter

And so on! It's always pretty easy to fit a serving of green veggies in with whatever meal you like - green veggies are usually very low in calories, but they will help fill you up and provide you with some fiber and nutrients. Talk about a win-win!

Fat loss is hard, but it doesn't need to be overly complicated.

Hope this helps - always here if you need me! 

- Julie