Responding to Readers’ Questions on Weight Loss

Jun 18, 2015 · 118 comments
Slow fuse (oakland calif)
A calorie is a calorie in the same way that an inch is an inch The benefits of exercise are many,but the main benefit is not weight loss;it is seen in circulatory,respiratory,and other systems. There is strong evidence that one's thinking and psychological state benefit, and I generally feel better when I do exercise Weight loss for myself is best done by cutting back on oils,sugar,and eating more roasted,boiled ,and/or steamed food. I also restrict the amount of salt I use to avoid hypertension. We use X amount of calories a day. If we eat more than we need;then at some point we start to store the excess as fat. Pick what works best for you and choose happiness
Roberta Russell (New York City)
I agree, losing one pound of fat is more quickly accomplished by not-eating 3,500 calories that you burn.

The big problems with regard to long-term weight loss are that food is addictive and sustained regular exercise, difficult to maintain.

I have lost 70 pounds and stayed at normal weigh for 15 years now. I managed this after many failures and an extended study of the peer-reviewed long-term (5 years) outcome research. Once learning the secret of success, logging and accountability, I started free groups, now on line, too.
Doing what works will make you successful in the long term weight loss challenge. There is no mystery.

If you want to join the no cost, except motivation, alliance, see my method and story in detail on the www.permanentweightloss.org web site. There you will find a video and before and after pictures of me.

After that, if this interests you and if you are over-weight or obese by less than 100 pounds, and you think you are motivated enough, contact me at russellk100@ gmail.com.

See you lighter soon?

Roberta Russell
bjwalsh (california)
I am glad Mr. Carrol's response clarified for me what his target argument is, and I would agree. For health (not weight) purposes, I cut out added sugars, all high fructose corn syrup, and many carbs, focusing on vegetables, fruits, plant, fish and poultry protein, with good fats from avocados, coconut oil, olive oil and nuts, and, as a "side effect" lost over 10% of my body weight, easily, and look better and feel better than I have in years. Exercise has been important for my health improvement, but based on my habits, I attribute the rapid and sustained loss to my changes in diet. Especially sugar.
flyoverland resident (kcmo)
while I didnt read your original (traveling, more later) after literally 40 years of doi9ng everything from h/s sports to martial arts at a high level to triathlon to power lifting to now, a combo of crossfit and HITT (intense boot camp) and having decent but not great numbers for b/p, chol, % body fat, I have realized you are absolutely dead on- its what you eat.
when I was swimming 4mi, running 30mi and biking 150m/week, I ate about anything put in front of me -and had a total chol of 260. not kidding.
when I was powerlifting and put on 40# of muscle, my BMR went sky high but I still had to take a statin.
now that I do HITT 45min 2x/week and crossfit 1x/week (I rebuilt muscle mass so quick thats most lifting I can do) AND watch mt diet, Ive dumped the statin, my bp is 115/75, my resting heart rate 55 and I sleep like a baby. you might also mention fitbit type trackers for sleep tracking as very helpful also. Ive finally got to where I want to be b/c of as you say, diet.
Mike (AZ)
on august 19 2013, my body fat % was 20.5 percent and my weight was 249. today (august 20, 2015) my body fat % is 12.7 and my weight is 242.7.

The changes were largely diet related. I eat healthy fats (avocados, peanut butter) fresh fruit and raw vegetables...i also include lean meats and some fish...i supplement with non-fat greek yogurt (Fage is my personal choice) and two eggs....

i walk low intensity for 30 minutes about 3 days a week...the speed is 3.5 miles an hour and the incline is 3....i picked this up from an active metabolic assessment that indicated my highest fat burn is in zones 1-2 with heart beat around 124....i complete a two to three hours of high intensity training with TRX conditioning....weights...lots of mobility exercises and strength training...for quite some time i participated in Kyokuushin Full Contact martial arts with each session lasting about 2 hours...

IMHO, the single biggest contributor was diet change....all of the exercising was making a change but once the diet changed then the whole picture came together....

it's been a lot of work and commitment and many days did not feel like doing any of it...jelly donuts...cakes....sodas....but I would say about 90% of the time i have stuck to the regimen....

the long term benefits are endless and those benefits push me in my goals....i love my life as it is but i do not want the ageing process to be more painful and debilitating then it inevitably becomes....
Sondra (San Diego)
Simple fact: when you're exercising you can't be eating--so that's another support for the exercise-leads-to-weight-loss adherents.
NJF (New York)
Say yes or no all you want...it is so true. Damn, it's what you eat. No doubt about it.
gjdagis (New York)
A healthy metabolism will result in a healthy weight no matter what the intake of calories is or the amount of exercise which engaged in. (I DO strongly advise that exercise be incorporated but for much different reasons than for losing weight for which it is virtually totally useless). The key to developing that healthy metabolism is a matter of what a person eats and not the amount of food that they consume. All grains, corn, potatoes, sugar, sugar substitutes, starchy vegetables, temperate zone fruit beyond a serving a day, fruit juices and processed foods must be totally eliminated. Fats, especially from tropical fruits, nuts (except peanuts, which isn't a nut anyway), grass fed beef, grass fed cows' dairy products, and fish should be eaten in the greatest amounts that can be tolerated each day. I have brought every single obese patient back to normal weight and every single diabetic patient back to normal if they followed these guidelines for just a matter of months. gjdagis FNP
SteveRR (CA)
What you are saying is not supported by a scintilla of evidence-based science.

It is totally how many calories you consume - period.

Metabolism (from Greek: μεταβολή metabolē, "change") is the set of life-sustaining chemical transformations within the cells of living organisms. These enzyme-catalyzed reactions allow organisms to grow and reproduce, maintain their structures, and respond to their environments.

And you somehow think that inside each cell is a dude with a mass spectrometer figuring out what type of calorie type is feeding the reaction so he knows to slow it down if it is 'bad' food
First Last (Las Vegas)
I stated in the original article, Calories In, Calories Out. Weight gain/loss , yes, some want to gain weight, is based on that simple premise. A 200 net caloric gain per week will result in an insidious weight gain over time. Overweight friends of mine, periodically, engage in radical diets, (No starch, high carb, fruit only, etc for a short period of time. Always, my suggestion to them has been, "Reduce your current meals by 10-25%. Keep going to McD's, IHOP, and Baskin-Robbins, but smaller portions or less frequent visits. Instead of a case of lite beer over the weekend, only consume 18 cans/bottles." Do it for three or four weeks, and then start fine tuning the diet and types of foods. Sorry, you gotta exercise a teeny itsy bit. But, you ain't gotta sweat. I walk will do it, and maybe some 5-15 lb weights. A loss of a 1 - 2 lbs a week is insidious also.
David D (PA)
I think Mr. Carroll is clearly supported by his data and has made some excellent points, especially about the individualized nature of diet and weight loss. In my story, I shed 50 pounds to go from a BMI at the upper limit of overweight to the mean of normal exclusively through eating less. It took about a year. I did it by finding a daily diet which worked, then eating the same thing virtually every day. You can't really control special occasions or visits from your mother. I get dumbfounded looks when I tell people this. I imagine this plan could work for other people if there were someone else willing to do it. I think Mr. Carroll's view of sustainability is important. Everyone must eat. Therefore, altering behavior in eating will positively impact one's health every day. Exercising, or not, is discretionary. I would argue focusing first on positive behavior in something we must do, versus something we should do, maximizes the chances of success. I personally found starting an exercise routine much easier at a healthier weight than my failed attempts when I was over-weight.
gw (usa)
Many commenters have asked, "When is a calorie not a calorie?" I think I can answer that:

If you refrain from ordering fries, but your companion orders them and you pick them off their plate, there are no calories because you were not responsible for their presence.

No calories to crumbs of any kind, after all, somebody has to clean up.

It is a virtue to neatly trim the uneven edge of a pie, cake or pizza, so no calories there either.

Ditto ridding a box, bag or plate of broken cookie pieces.

Also broken potato chips. And irregulars.

No calories to tasting things while cooking. 'Cause it's your duty.

No calories to getting rid of last of family dinner while clearing the table, because it's a sin to throw away pefectly good food.

No calories to free food of any kind, because, hey, why would anybody pass up free food?

For more examples, you will have to see my new nutrition book, but I hope this at least begins to solve the calorie dilemma.
David Lobato (Texas)
I see two important points missing in all the discussion.

One is that losing significant pounds is an enormously difficult ordeal with setbacks and triumphs. Other life achievements pale in comparison. People need to be warned that the road ahead is arduous, not for the weak. The human mind will find effective ways to subvert the best diet plans, no exceptions. And how many times the result is more weight gained? Success is possible with enormous focus and determination.

This brings up my next point. I never see it mentioned. Any weight one loses is fought mightily by the body's defenses to regain it, plus some. The urge to eat after weight loss has heroic proportions. Achieving a weight goal is just a small percentage of the total effort to keep it off. If one is really prepared for the very strong tendency to regain weight, it improves the odds of long term success. I have seen people lose a lot of weight after gastric bypass surgery, and be near their original weight a few years later. A strong and serious plan for weight maintenance is critical for weight control. Let's be honest, one's life will never be the same again. This is more important than losing the weight in the first place.
Dalgliesh (outside the beltway)
Part of the problem is that it is hard to get research funds for exercise and diet studies relating to healthy people. The studies are often statistically under-powered and limited in scope. Every disease has its lobbyists and interest group. If you look at PubMed, you are more likely to see publications about exercise and diet as they relate to a particular disease. So, we really don't know enough about the baseline "normal" for healthy people.
Xuan Loc 67 - 69 (New Jersey)
It's simple: stop eating bread. Within a week or so, you'll lose your craving. Same with cookies, cakes, all processed, packaged goodies which we know are larded with sweeteners and trans fats. Soon you'll be able to ignore them. without craving. I lost about 25 pounds.

After my stent, Seven months ago, I switched to Masley's & Esselstyne's plant based diet and lost another 20 pounds. Almost entirely with very moderate exercise.
Mark Oliver (Indianapolis, IN)
Each time I run my 5k - about 4 times a week - it greatly suppresses my appetite for up to 36 hours.
Yeti (DE)
Roseanne Barr once quipped, "I'll do anything to lose weight. Except diet and exercise." That was a couple of decades ago, if memory serves, back when I was a running monster and -- to use airborne terminology -- a "heavy drop." I have two obese marathoning buddies who, like I did, use their exercise to justify their extraordinary caloric intake. Now, with a failing aortic valve, I've had to obey my cardiologist's order to drop a third of my weight -- "1200 calories a day. No more. And exercise won't do it. You can't breathe anyway. Now get out of here." Six months later, and not a single drop of sweat, I'm within 20 lbs. of the mark. Thanks, doc.
gw (usa)
Aaron Carroll, I don't see any reason for you to apologize or explain. I too was bothered by the show, "Biggest Loser," as the exercise regimes the overweight people were subjected to were unnecessary torture that doubtlessly increased their appetites. Exercise is great for overall fitness, but it is dietary changes that make weight loss successful and long-lasting.
Frank Rosenthal, Ph.D. (West Lafayette, Indiana)
The scientific literature on exercise, appetite and weight loss is complex. Several studies have shown that strenuous exercise suppresses appetite and thus can be an importanat part of a weight loss program. For example, see the study by Sim et al in International Journal of Obesity (2014) 38, 417–422. (The paper is available at:
http://www.nature.com/ijo/journal/v38/n3/abs/ijo2013102a.html). This study was described in an article in the New York Times entitled: "How Exercise Can Help Us Eat Less" by Gretchen Reynolds, published on September 13, 2013. Weight loss (or gain) is determined by energy balance, i.e intake vs. expenditure. But Dr. Caroll's article ignores the vital role that exercise may play in modulating energy intake. The extent of the effect may depend on the particular exercise program as well as individual variability. But it is much too simplistic to dismiss the role of exercise in a weight loss program.
Sarah D. (Monague, MA)
The author seemed clear to me the first time around: exercise has important benefits, but for *most* people, control of food intake is more crucial to weight loss.

Along a slightly different line, the "a calorie is a calorie" argument baffles me.

A calorie is a measurement. Isn't a calorie a calorie in the same way that an inch is an inch? It seems that the question should be instead, what does it take (in effort) to burn a calorie?

Some materials burn easily. Some don't. Even different kinds of wood burn at different rates. At the risk of sounding simplistic, why would this not also be the case for calories in the human body? Some people burn calories more easily than others do, so it will take more effort from one person to burn ten calories than it will for another.
SteveRR (CA)
Well no - it would be like doing the calculation and determining that there was 31,000 kcal in a gallon of gas but if you burned it in a closed system - you were only getting 21,000 kcal.

The energy has to go somewhere - there is no parallel universe that stores up energy.
mdieri (Boston)
After all the rehashing the author still comes up with a faulty conclusion in his last sentence: "Weight control, unfortunately, just doesn't seem to be one of them" regarding the benefits of exercise. On the contrary, exercise is extremely helpful in weight CONTROL (e.g. maintaining a healthy weight and avoiding weight gain over time) even if exercise alone may not lead to weight LOSS.
Jenifer Wolf (New York)
You are correct. I lived on Maui for 2 1/2 years in the late 70's. I have never led such an active physical life, before or since. I swam miles in the ocean at least every other day. I climbed in the hills. I searched for firewood for outdoor cooking. I have never been so strong, healthy and vigorous. I also put on a lot of weight I went from 115 to 145, because all that strenuous physical activity made me feel starved. I had never been really interested in food before. At one point I got a staff infection. My leg blew up. I couldn't even walk. I was in the hospital for 10 days, lying on my back. I lost 15 pounds. Because the weight loss was so effortless, I was encouraged to lose the rest of what I'd gained, although it did take effort, over the next several months. Exercise does burn calories. It can also increase your appetite.
Sherry bruck (New eochelle)
I agree 100%. Exercise is great and I workout, walk, bike, ski...but none of those activities lead to weight loss. It was only when I restricted my food intake that I achieved success. Exercise made me hungry!
Stacy (Manhattan)
I think one of the important ways to eat less (as the original article urged) is to make sure that most of the food you do eat is nutritionally dense (as opposed to merely low cal).

Until the 1980s, when Americans began to balloon in size, people routinely ate several highly nutritious foods, some on a daily basis: plain milk, liver, eggs, oats, beans, spinach, carrots, cabbage (cole slaw, sauerkraut, etc). As an example that now seems impossible, my high school cafeteria in the 1970s regularly served liver-and-onions - and the kids actually ate it. Some students were really fond of it. I confess I wasn't one of those, but I did eat it, if begrudgingly.

Yet, four decades later, many people, and especially children, NEVER eat ANY of these foods. They've replaced them with higher-calorie and often nutritionally void substitutes (soda or chocolate milk for milk, bagels and cream cheese for oatmeal or eggs, boxed mac-n-cheese for beans, french fries for veggies, etc). Just to be clear, I'm not arguing that anyone has to eat these exact foods to be healthy - they are just examples of good, plain, healthful food choices that pack a nutritional wallop.
Karen (Denver)
My personal experience with weight loss indicates that diet is much more important than exercise for me. Vigorous cardiovascular training stimulates my appetite, a reality I had no choice but to face while preparing for a marathon. Over a year of intense running put twelve pounds on my frame. I was always famished and ate like it was going out of style! Afterward, I fell into an exercise slump and dropped twenty pounds without much effort at all. I simply wasn't hungry.
Billy Romp (Vermont)
Addressing readers' comments is admirable.But why include the clueless and inane? Such as "it worked for me so how can you be right?" and "you are trying to say we should be sedentary" and the winner: "there are no obese marathon runners" (I can just see the smug, arms crossed, sneering jerk--"See? I must be right!")

Additionally, 30 minutes of exercise, even if it's six days a week, seems like a pretty low bar. Most exercise advice includes stretching, warm-up and cool-down routines that take that long themselves. An athlete who devotes 30 minutes a day to training does not advance. A musician who devotes 30 minutes a day to practice does not advance. Why should we advise, and expect results from, minimum effort?
Molly Mu (Golden, Colorado)
Diet and (and I stress and) exercise are important in losing weight. Research has shown people who maintain successful long term weight loss exercise 1 hour a day and keep a food log of their caloric intake. This regimen is for people who have weight problems. As my endocrinologist explained to me, people are different and people with weight problems have to think of it as a chronic disease that has to be attended to throughout life. When I fail to do exercise, I put on weight regardless of whether I control my intake, when I attend to exercise and diet, I lose weight. For my body, exercise is essence, because cutting intake causes my body to scale down its caloric consumption. I always say, come the famine, I would be in great shape.
InNJ (NJ)
The reason the author got so much blowback is because most people think only of themselves and what works or doesn't work for them. It's all about them personally, totally lacking in empathy and understanding. Few can see the big picture and consider the difficulties others might face in dieting and exercising. .
David Prichard (Urbana IL)
The problem is that a pound isn't a pound- even if an intensive exercise regimen doesn't lead a person to lose weight, if they are making fitness gains then they are also gaining muscle mass- and losing fat.

People don't necessarily want to lose weight, but they often see that as being most attainable way of slimming down and be healthy. But you can do that by trading fat for muscle, and you can't do that with diet.
Gina (California)
I weigh 100 pounds at 5 feet tall. If I ever want to eat a slice of cheesecake I need to work out. So I do, every single day.
Cantor43 (Brooklyn)
When you consider how many people misconstrued and distorted the intent of the original piece, which was stated very clearly and plainly, is it any wonder that our democracy, which depends on a well-informed citizenry, is in such a mess?
Julie (Cleveland Heights, OH)
Here's the problem Aaron, the large majority of those commenting do not understand research. Many of the comments discuss their own anecdotal experience which is NOT what research entails. Therefore, I can hypothesize, with high probability, you will always get these comments in response to many of your columns. But keep them coming; as I scientist I love them!
CC (Massachusetts)
Though you are correct, the media in general deserve some of the blame. Each new study is heralded as 'the answer' to some question; headlines make claims such as "Study identifies cure for cancer" and other such nonsense. The fact is that epidemiological studies tell us about patterns in populations; they are not prescriptions for individual human beings. Without knowing the control variables and the full procedural for a study, it's very difficult for an average citizen to know how to assess findings. It is the job of our news outlets to more clearly explain this IN EVERY ARTICLE. The original column referenced here was reasonably good, but still wasn't sufficiently explicit in describing how epidemiological studies work and how they are best understood.
What3231 (Illinois)
Both the original article and this one are receiving hostile blowback. Yet, the author went out of his way to be even handed and open minded about the topic of exercise and weight loss.

He unambiguously stated that exercise is necessary for good health. He simply pointed out that calorie reduction is essential for weight loss.

None of this is new. But people are so invested in their own truths about weight loss, they refuse to see what seems to work on a broad scale.

And there's an ugly undercurrent of moral judgment in many comments. Weight is the focal point of much prudery in the comment sections of this paper.
Old School (Md)
I weighed 185 and lost 35 lbs. I exercise 4-5 time/wk. usually running 30-60min with some weight training sporadically in addition. I really never lost any weigh with all of that. (15yrs) When I limited the amount I ate to about 2000 cal/day, cut out sugar altogether and began a modified vegan lifestyle, I lost the weight very quickly. I've since stabilized at 150, maintain exercise level and diet I described for last 2+ years. Once you become accustomed to it, it isn't difficult at all.
Joyce (New York)
Agree with your conclusions but worth mentioning that exercise can make a difference at the margins. I eat sensibly and don't have any high calorie items such as soda that I could easily cut from my diet. Burning 200-300 calories a day exercising is a better option for me than trying to find a way to reduce my diet by that amount.
paul (Houston)
One factor he missed is weight training. An extra 10 pounds of muscle will burn ~100 calories/day at rest, in addition to the calories burned working out.
AntoniaJames (Northern California)
paul, that is so interesting, and helpful! What is the source of that assertion? i don't doubt that this is true. I'd like to be able to pass the information on, but of course need more evidence than, "Some guy commenting on a New York Times article said . . . " Thank you so much.
anniegirl (Washington, DC)
As I have aged to 64 and still work in a sedentary job I find it harder to exercise on a regular basis but do what I can. I am convinced that Mr. Carroll is right and that exercise alone won't keep off weight. The most effective thing I do to lose weight is to bring my lunch from home or concoct a small portion of protein and vegetables in my company cafeteria. I can't lose weight eating the huge portions doled out by every merchant arount me. This includes Chopt (too big, won't keep 'til tomorrow once the dressing hits), Roti (love the salad but again way too large a portion), Chipotle (same), and all the food trucks near my office. I use Lose It to track my calorie intake and that works for me. Good luck to everyone on staying healthy, using what works for you.
Catherine (New Jersey)
I'm one of those people for whom exercise....and a specific type of exercise....is the necessary ingredient for remaining slim. That exercise is weight training.

The problem with most written communication on the subject, including both your earlier column and this one too, is that a truthful claim of "This works better than that" actually requires defining what you mean by "works." We might all be saying "lose weight" when what we want is to lose fat and keep that excess fat off our bodies. If you are fat because you eat too much, you've got to eat less. But if you also are fat because you are sedentary, losing weight by caloric restriction will cause you to lose water and lean muscle mass. The scale will move, and weight will be gone, but too much fat will still be there -- on an even slower metabolism. But if the only yardstick for success was loss of weight, not fat -- enjoy your brief moment before it all comes back.
Hard, physical effort is a necessary ingredient in a fit life. There is no short-cut, no diet, no cleanse to get you there. If only for the health of your bones, you should do weight bearing exercise that challenges you, and combine that with enough calories of healthy food to fuel your body.
Wright Frank (Washington, DC)
Okay, I'm convinced. But the logical next question for me is, "what matters more for health"? Assuming I have a limited amount of will-power--if I'm after longevity rather than weight loss, should I spend that will-power on exercise or weight loss? Assuming I can't have it all, should I be skinny and weak, or an overweight (not obese) and buff?
Jane Mars (Stockton, Calif.)
That's a great question. I want to know the answer--because evidence suggests that people do have limited will power. I'm guessing the answer is overweight and buff...I think the benefits of exercise in terms of being healthier older trump the impact of a few extra pounds, but I'm curious.
Naomi (San Francisco)
I don't know about longevity, but I always focus my efforts first on exercise, because, while I do want to lose weight, I also want to be less stressed/anxious/depressed (and decreasing those factors will also reduce my emotional eating, and has been shown to aid weight loss or maintenance); maintain my bone density; and remain more flexible, more fit in a cardiovascular sense, stronger, and better balanced, as my age advances, than my parents. I'm also one of those people who finds that, at least in the short run, certain types of exercise curb my appetite.
Sue (California)
I just finished reading Linda Bacon's Health at Every Size. She points out that people classified as overweight and even obese actually live longer than people classified as normal weight. (At a certain point, obesity starts mattering, but not at the lower end.) So if you have to pick one, it sounds like weight loss is less important than exercise for a longer life. (Personally, I'd rather go for moderate exercise and mostly healthy food, rather than picking between exercise and diet.)
Mlc (Durham, NC)
It is clear from your original article that what you eat matters more than how much you exercise if you are trying to lose weight. Given that, my takeaway is that if I only have an hour a day to spend on myself I'm better off using that time to buy and cook nutritious, healthful food. If I have extra time, I'll go for a walk, or try to fit in walking and stair climbing as part of the rest of my daily activities.
Pat (NY)
Regulated diet and aerobic fitness, if you eat only what your body needs to keep itself healthy then your body will over time become the size it's meant to be. For me (a carb addict) the key was eating healthy carbs on certain days and sticking to mostly protein and vegetables on days in between. It's tricking the body into burning fat for fuel and at the same time prevents your body from adapting to your eating routine (more details: http://everydayhealthhero.blogspot.com/can-carb-cycling-help-you-lose-we... ). Been doing this for about 3 months and it works GREAT for me. I am never hungry and that's the part that makes it successful to me.
jh (Los Angeles)
I think a big part of why so many americans are obese is portion size. Earlier this year my fiancé got worried that he was gaining weight. He came up with a genius solution: whatever food he was served, he immediately took half and put it away. At restaurants, this meant asking for a to-go box as soon as they brought the meal. At home, the extra food went right into the fridge. when he finished his plate he’d wait 10 minutes. If he was still hungry he’d go for the rest. This rarely happened.

After a few weeks of this, he stopped needing to physically remove the food. He couldn’t imagine eating the whole serving anymore. Turns out, he never needed to - he’d just thought he did because it there in front of him. His weight dropped back to his goal, and he stopped going into food comas from overeating.

The great thing about this was he didn’t deprive himself (though he did cut down on ice cream - more for me!). He just made the amount he ate a conscious choice.
John (Austin)
Yes, this is exactly what worked for my husband and me. No special diet, just eat less of what we had been eating (which was a balanced diet). And you do indeed adjust and it becomes the new normal.
Gina (California)
We take our own plastic containers to restaurants and put half away as well, right off the bat.
Mike Smith (Philadelphia)
If the science is showing that diet is more important for weight loss than exercise, but also that exercise is still important for health, it seems that optimal health needs both good diet and exercise (duh).

The problem with the article (or its interpreters) is that it seems to imply that weight loss is the primary goal of health. But who cares if you're overweight, if you exercise lots and have the heart and lungs of an elite athlete? Maybe that's medically impossible. Extra weight is clearly a risk factor for many health issues. But a better sense of proportion between losing weight and physical activity in terms of overall health would have been welcome.

That is, how many and what type of health risks do you minimize when you just eat right and lose weight, versus how many when you also exercise regularly? If I have limited time (when this dichotomy is true for people), should I spend more time cooking right or running--not just for my waistline, but for my health and longevity?
Nancy (<br/>)
learn to cook. anyone can put together a nutritious meal in fairly short order. Nothing I cook takes that long actually at the stove or cooktop. I can wander away and do other necessary tasks while things bake or simmer after spending fifteen minutes getting it going.. Eat the leftovers the next day.
I can make a lunch to take in ten minutes or less, sandwich and fruit and or cheese.
Then you have a half hour to take a walk after dinner.
Richard (Bozeman)
For most folks, eating less outweighs exercising more. But, certainly exercise can in extreme cases overwhelm diet. Cyclist Michael Rogers won Stage 16 at the Tour de France. Rogers was in the break for six hours. Over the 237.5km stage, he burned 6,639 calories and climbed 9,594 feet. On the crucial Port de Balès climb where he made his attack, he averaged 428 watts for just over 35 minutes. Rogers lost weight, because he was not able to consume 11000 calories that day. The body is capable of so much more than a typical exercise regimen might suggest.
AW (Buzzards Bay)
Finally, I am easing up on exercise and taking another look at daily caloric consumption. As a highly functional post polio, I cannot endure sweat producing weightbearing exercise. I am changing my focus on my swimming experience as relaxation and not calorie burning.
Doctor Shiller (new york)
Dr Carroll makes important points in original article. Indeed the research doesn't show great effects of exercise in persistent weight loss.

So why did he get enough questions and objections that he had to write a response to his readers questions? I suspect he's missing an important principle about the relevance of research.

Research looks at populations. Research outcomes are relevant to individuals who are 'the same' as the people in the research. And when it comes to the effects of lifestyle interventions like diet and exercise, we have a very crude understanding of all the variables. There are so many differences among people in their physiology, motivation, behavior, culture, etc. All of these variables can impact the outcome of research on exercise or diet and weight-loss. So there may be large numbers of people for whom 'the research' just isn't relevant.

In the end of this article, Dr Carrol says, "I stand by what the evidence shows. What you eat is more important to achieving a healthy weight than how much you exercise. If your goal is to lose weight, then you are more likely to get better results in the kitchen than in the gym.... There are many, many good things highly associated with exercise, and all of them matter. Weight control, unfortunately, just doesn’t seem to be one of them"

Bad Conclusion!
His statement is only true if 'you' are like the people in the studies. Maybe that's why he got so many objections and questions?
Food for thought
Nancy (<br/>)
They objected because they are really in love with eating a lot of food, more than in past generations. Look around you and compare how everyone looks to how they looked in street photos in say the 50's. Everyone is fatter than before. and it is not muscle either.

One mistake (avoidance mechanism?) I think people make is a reluctance to believe what is really obvious and state they need 'studies' before altering behavior. People know, they are just resistant. thus the vehemence of the objections.
The Pooch (Wendell, MA)
For all the "a calorie is a calorie" folks, here's a thought experiment: Compare 500 calories of cookies and soda with 500 calories of fish, olive oil, and vegetables. Which one is more filling? Which one will keep you feeling full for longer? Does the "satiation value" of these two meals have anything to do with calories?

Physics is true, but humans are not bomb calorimeters, and different types and nutritional qualities of foods are metabolized with different efficiencies, and have vastly different effects on hunger/satiety, metabolic rate, blood sugar balance, and fat storage. Physics does not specify whether a process will be conscious or unconscious. If we have to "manually" and consciously count calories, then something is already wrong with our hunger/satiety mechanisms, the types of foods consumed, or both.
Anne-Marie Hislop (Chicago)
Interesting that you got blowback since what was written was hardly new news. It has long been true that a combination of improving diet (healthier and/or less food) along with becoming more active was the key to both weight loss and maintenance of a healthy weight.

That said, there are a range of body types, which respond in a variety of ways to food and exercise. I have known my share of folks who would be considered overweight, but how exercised vigorously (spinning classes, running) several times a week. I have also know the proverbial skinny person who could and did eat anything and rarely exercised. All any of us can do is live as healthy as we can - exercise for our hearts, our muscle tone and good balance, and to sleep well AND eat as healthy as we can as often as we can.
WastingTime (DC)
More non-news. Losing it is easy. Keeping it off is really really really hard. I have been up-and-down at least six times in my adult life and I'm up again, heading down. It is diet, it is exercise, but those things are trivially easy because the real problem is still will power and that's really really really super-hard to sustain. Especially if you respond to stress and emotional challenges by eating.
Blaine Wishart (Italy)
I think the article does a good job of showing that for most people diet is more important in weight loss than exercise. The article also points out that exercise has many additional benefits.
One key issue remains: which is most important for real health -- fitness or weight loss.
Both are valuable, but I think its clear that for longevity and energy for daily challenges, fitness takes the cake -- for most people.
Steven Arnold (Bay Area, CA)
Thank you for a well-written article that helps dispel some myths about weight loss. While it is possible to lose weight by exercise alone, most people who are chronically overweight or obese (about 2/3 of the country) will not jog for an hour a day. While "lifestyle change" sounds scary, in fact we do need to change our eating habits. That doesn't have to happen overnight. It can happen incrementally, a little bit at a time. The trick is to not get discouraged and quit. In our practice we have found that nutritional education and support are integral components for long-term weight loss. Unfortunately medical science is all over the place, with scientists looking for the so-called "fat gene," others touting miracle cures in a bottle, while still others simply advising patients to "eat less and exercise more." As you suggest in the article, a calories is a calories. Finally, we shouldn't confuse fitness (i.e., "working out") with diet. Both are part of a healthy lifestyle but they are not the same thing. Simply put, to lose weight, we need to cut calories.
W. D. O'Neil (Falls Church, VA)
I've lost 41 lbs in 42 weeks. I decided that I needed to do it on a basis that did not demand a great deal of "will power," because that would distract me too much from getting on with my life. I eat more or less what I always ate (including sweets), but pay close attention to whether I really feel that I need that additional bite. At restaurants I'm careful to order things that travel well so I can take home the portion I don't eat.

Exercise has been an important part of my program. I work at home as a writer and have an elliptical trainer, which makes things a lot easier. I exercise on it three times a day, 20 minutes each, reading or watching videos, at a level that consumes nearly 500 kCal per day. Since a pound of fat represents 3500 kCal of food energy, and I exercise 7 days per week, this really is quite significant.

Not for everyone, I fully understand, but I think the principles do have broad applicability. Do something that you can put up with indefinitely without feeling burdened. Yes, be realistic about the limitations of exercise, but also its power not only in general health but as a part of a weight-loss strategy. Be patient and recognize that your weight can rebound for a few days simply because of fluids balance without indicating that all is lost. However you do it, if your energy expenditure exceeds your intake by 3500 kCal you will lose a pound of fat; it's basic thermodynamics.
Sophia35 (USA)
Your eating habits, specifically how much (or little) you eat is the key to weight loss. I exercise often and eat healthy: lots of fruits and vegetables, no fast food or soda, minimal sugar. The problem is I eat too much. I absolutely love food and cooking is my main hobby. I don't want to cook or eat less so I guess I will just be overweight even though I eat healthy food and exercise all the time.
Yeti (NYC)
As I travel by train from Brooklyn to Manhattan, I notice a decrease in the BMI, meaning people look slimmer. Do Manhattanites spend more money on rent than food? Or do they go to the gym more often? Are they younger, and therefore had not enough time to accumulate fat? Or maybe something else?

Manhattan reminds me of my country of origin, a third world country when I left it, now medium-highly developed. There were no elevators in the majority of the 4 stories buildings, few cars, overcrowded public transportation and no school buses. I used to travel to school hanging on the bus steps with the doors locked open during winter or summer. There were no cell phones, no checking accounts, no internet, no phone, no catalog orders or home deliveries. I stayed in line for everything from bus, to doctor, to gas, telephone or electricity payments. sweating during the summer and shivering during winter. I never went to the gym, although as a kid, I was out in the street, playing, roaming the city or fighting with my peers unsupervised, with the apartment key hanging from a string around my neck. I used to come home long after sunset.

15 years ago, I ate more than now but was 150 lbs lighter. I never ate or drank anything considered fake by local standards like low fat, low calories or containing artificial sweeteners. But because of the prolonged, low intensity and varied effort, life was bearable. And much healthier.
Sally (Switzerland)
I believe there is a huge correlation between wealth/poverty and being at a healthy weight/overweight. You probably observe this correlation when you travel from less wealthy Brooklyn to wealthy Manhattan.
Of course, this correlation is probably due to the availability of better food and the luxury of having time to prepare it - and that fancy gym membership might help out.
You can also take your fate into your own hands. Eat a healthy diet, and use the stairs, even if there is an elevator in the building!
Frequent Flier (USA)
Everybody knows how to eat better, but almost nobody does it. Comfort food is addictive. Sugar is addictive. Mix that with sedentary lifestyles and real-world issues -- underemployment, stress at work, mean girls in school -- and the solution is to reach for comfort food. If eating better was so easy, we'd all be thin.
Rebecca (NY)
Here's how I think about losing weight-
Your body is mostly composed of carbon, oxygen, and hydrogen. Take out the oxygen and hydrogen, that's water. That leaves carbon. We gain carbon through the food we eat. How do we lose carbon? Exhaling. Yes, breathing. Now think about the two ways to lose weight. You can increase the number of breaths you take per minute by being active. Or you can simply eat just a bit less. Tell me, which seems to be the faster method to lose weight, not eating a donut for a mid-morning snack, or trying to exhale the equivalent of that same donut?
Chris (Florida)
Why do people persist in excuses? If you burn more calories than you take in, you will lose weight. Period. Vigorous exercise or not. All the talk about genetics and the type of calories consumed or the type of exercise performed amounts to one thing: An excuse for taking in too many calories. Aka, weakness. Face it, deal with it, change it.
Reader (Westchester, NY)
I say the same thing about taking calculus and organic chemistry. If you just go to class and study, you'll get A's like I did. Why do people persist in excuses? After all, we all have the exact same brain and body, no matter what our age, gender, hormones, lifestyles or medical conditions, so everybody should be able to do exactly what I did, and I have every right to think that anyone who hasn't taken those classes and gotten an A is just showing weakness. And I also have the right to look down on them cause, hey, even if the experts in the article say that it's a "very individualized thing," and that things don't work the same for everyone, I'd rather think that I'm better than everybody else. So shame on all the people that struggle with math and science.

After all, I think everybody should know chemistry and calculus, and if I feel that way it must be true. It's really annoying that I have to pay more for education cause other students need things like office hours and tutors. And then these disgusting non-organic chemistry taking people get to vote on laws that affect me, even thought they don't understand radioactive dating.
People should face this and deal with it, and then change it.
Sarah (Cleveland, O)
It's totally an individualized thing. You're equating larger size with moral failing. I watched my parents eat the same diet growing up. Day was a lean stringbean and did no exercise outside of gardening. Mom seemed to gain at the mere sight of food. I'm like her. I have the reputation of being the healthiest eater and most active of my friend group, the one who hikes and bikes and surfs and shows up to parties with a veggie tray. I'm also the heaviest, despite minimal intake of processed food and refined carbs. Every doc who first meets me assumes hypothyroid after taking my history - but I'm on the low end of normal. I don't look as good in a sundress as I I'd like, but instead gain satisfaction from showing up those who discount my abilities on account of my size. Also, I look 10 years younger thanks to a fuller face. Totally individualized.
Sally (Switzerland)
What you eat plays an important role. In particular, refined sugar leads to insulin spikes in your blood, which locks sugar away. With the excess insulin, you end up with low blood sugar and extreme hunger. If you drink a coke or eat a jelly donut to take care of your hunger, you get another insulin spike...
Choosing what you eat makes a huge difference. The sugars in fruits are released gradually, leading to a gradual release of insulin. Whole grain foods are also digested more slowly and leave you satiated for a long time.
The type of calorie consumed makes a huge difference!
closeplayTom (NY LI)
Quick thought on the silly meme about marathoners not being fat, etc, etc...pick an athlete and the silly myths about them.

You will not find an elite, or a healthy and truly fit amateur marathoner who was obese and "ran it off". You will not find a truly thin person who was capable of bulking up to being Mr. Universe. (without an abundance of steroids)

Most successful athletes gravitated to the sports that their body-types would be most successful in. You won't find an NFL lineman body type on a tennis court getting a scholarship for it. And vice versa.

People should gravitate to sports, or athletic fitness endeavors that are most suitable to their body types. Its not that you cant dream, I would love to look like an olympic sprinter, but Im no longer obsessed over getting there. I still sprint, as I love it, but that muscled body type aint gonna happen for me.

Also; start focusing on being fit in the shape You ARE IN, and stop obsessing over being in the shape you are not fit to be in!
EndOfEmpire (Kihei,Hi)
"You will not find an elite, or a healthy and truly fit amateur marathoner who was obese and "ran it off"." Really? My BMI qualified me as obese, and I took up triathlon and marathons, lost 50 lbs, and the weight has stayed off for more than 15 years. I was never a runner or athlete until my late 20s. I am certainly not an elite, but I am in the top 6-10% of most triathlons I compete in.
mac (louisiana)
i felt that there was a bit of a problem with the representation of the analysis study findings that Mr. Carroll reported on in his article in upshot yesterday: when the actual article is reviewed it indicated that combined programs involving dieting, physical exercise AND behavioral components, i.e. strategies for losing weight, were superior not only to physical exercise only weight loss programs but to diet only programs at 12 months. The combined program was slightly better than the diet only at 3 to 6 months and physical exercise was the least effective in terms of weight loss in the short-term. But based on the study, it is the combo that was most effective over the long haul. A big problem with the study is that it focused on weight loss only and did not report on changes in body mass index, so we have no idea whether those in the physical exercise only and the combined programs faired better than dieting only groups on this more important measure of health.

Here is the link to the article in the National Institutes of Health data base if interested in taking a look for yourself:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4180002/#!po=41.6667
EaglesPDX (Portland)
Since it is calories in/calories out for weight control, exercise is part of the equation and Mr. Carroll seems to press a bit to hard taking the "calories out" out of the equation.

The real key is strict measurement of calories in/calories out via one of the phone apps that do this so well, allowing people to rigorously track their calories in and calories out to know if they are gaining, maintaining or losing weight.

Without exercise to burn calories, build muscle which increases caloric burn at rest, to add stress to build bones, increase aerobic capacity it is very hard to maintain or lose weight.

As always balance, which Mr. Carroll tends to ignore, is the key. Matching diet to exercise, measuring calories (food) and calories out (exercise) is key.
The Pooch (Wendell, MA)
Who says we have to measure calories consciously? Do we have to consciously count ounces of fluid in and out to achieve water balance? Do we have to consciously count rate and depth of breathing to get the right amount of oxygen?
Richard H. Serlin (Tucson)
As far as, a calorie's a calorie.

I think there is some decent scientific evidence is that it's not. Mainly, you should have read:

-- The China Study, by seminal nutritional scientist T. Colin Campbell, of Cornell

-- Eat to Live, by Joel Fuhrman, M.D., not perfect, but lots of good science

It's not some non-scientific, mix certain foods, it's basically healthy foods appear to make the body regulate and dispose of extra calories better, with healthy foods being whole fruits, vegetables, nuts, etc.

Also, you should be reading the mounting good evidence for intermittent fasting, I can tell you from studies and personal experience it's a lot less hard than most people think, and highly effective and lasting, so far, compared to other methods.
The Pooch (Wendell, MA)
A different perspective on The China Study:

http://rawfoodsos.com/2010/07/07/the-china-study-fact-or-fallac/
SteveRR (CA)
Here is the definition of a calorie: the energy needed to raise the temperature of 1 gram of water through 1 °C (now usually defined as 4.1868 joules).

Assuming that you believe in the conservation of energy - tell me - what part of that definition depends on the kind of food supplying the calorie.

If I get a calorie to run an engine from a regular octane gas am I getting magical calories from high octane gas? Or am I getting the same calorie regardless

If you said no - I assume you are also the kind of guy who 'pampers' his car by giving it high octane gas for better performance.
teo (St. Paul, MN)
Exactly right. Diet. The vast majority of us lose weight or gain weight because of diet. I mean, even if you think about this logically, this is the only answer:

Suppose I eat 2,000 calories per day and I eat less than 65 grams of fat per day and I amaround 200 pounds. Just simple math. And let's say I run for 30 minutes per day and burn 400 calories. Net -- just based on this data set -- I have 1,600 calories (I know, we burn when we sleep and when we walk and etc. but this is just a hypothetical).

Now, suppose I eat 3,000 calories per day and I eat around 100 grames of fat per day. And suppose I run for 40 minutes per day, burning 500 calories. I am still netting 2,5000 calories per day. You can't get there on exercise. Simple math, people. If you have a mediocre diet your exercise won't make up for it.
George N. Wells (Dover, NJ)
The simple energy equation rules: Calories in minus Calories out equal either calories lost (lower weight) or calories retained (weight gain).

Exercise/movement of the muscles and skeleton, is part of life and generally the more you move the more energy you use and eventually (ever so slowly) if your daily equation run in the loss column you will lose weight. Exercise generally, but not always, assures that fat, not muscle is lost. Combining portion control and regular exercise is probably the most effective path to weight loss and improvements to overall health.

I accomplished a loss of well over 70 pounds by the combination and change in lifestyle from a sedentary person to an active bicyclist/tandemist my wife lost over 50 pounds in the same period of time. Occasionally, weight creeps up and we have found that restrictions on intake get the weight down faster than increases in activity supporting Mr. Carroll's assertions.

Unfortunately we over-estimate the caloric consumption of exercise and under-estimate the caloric value of foods eaten or drunk. We also live in communities and work at occupations that require long periods of sedentary time compounded by long sedentary commutes and pre/post work schedules that make exercise next to impossible. Finally, we are always being sold the efficient exercise, not the effective exercise that we actually enjoy.

Boot-Camp type exercise based TV programs are great entertainment but not guides to a new sustainable lifestyle.
The Pooch (Wendell, MA)
Physics is true, but it does not tell us what is cause and what is effect in a biological system. For example, a child going through a growth spurt eats more than he burns. But is he growing _because_ he is eating more, or is there some underlying biology that governs both growth and appetite?

And who says we have to balance calories consciously? How does the body achieve its other balances and regulations?
Tracy (Chicago)
So many people think that they can just "hit the gym" and exercise off an indulgent meal - think of the special exercise classes that many gyms run on the day after Thanksgiving. My dietician calls this exercise bulimia. There are many good reasons to exercise - releasing positive endorphins, reducing blood pressure and improving heart-health, but you simply cannot out-exercise poor diet choices.
Rex Muscarum (West Coast)
I have worked out since the early 1980s. To me, 10 more reps in the gym is much easier to do than to say no to a single donut. I think this is why there are so many gym rats who are rather muscular but still a little chubbier than need be. However, in the pursuit of a lean, muscular body, and assuming you do a fair amount of weights and cardio, it's still probably 70 percent nutrition (read eating less in general and less carbs) and 30 percent exercise. Those of you in your 20s to early 30s may disagree, but show me a lean 40+ man or woman and I'll show you someone who has seriously worked on their eating habits or who has a very rare metabolism. Long distance runners don't count - they blow most people out of the water and put in more caloric exercise than any "average" gym-goer.
Frank (Oz)
interesting - you have the willpower to exercise at the gym, but not to resist donuts ?

yes I think the processed food industry is interested in protecting their profits from high-energy (mostly sugar) junk foods - and in promoting exercise as a distraction from the reality that you can swallow in seconds more calories than you can work off in hours at the gym.
Sophia35 (USA)
I am like you too. It is much easier for me to exercise then it is to say no to food, especially sweets. See the thing is I absolutely LOVE to exercise. Nothing makes me feel better then an intense session at the gym. The problem is I also love food and cooking is my main hobby. Why would I want to cut out what I love: lots of food and exercising all the time, for something I don't love: less food and less exercise?
Michael (Los Angeles)
You'll have to do approximately 10 thousand reps to equal one donut. Weights burn very few calories.
Seymoza (MI)
I disagree with the general sentiment of the original article and the follow-up. He's a fundamentalist and his one size fits all argument is largely bogus.

I'm a doctor, but the evidence for dietary intake and exercise are not on the same plane (perhaps simply bc diet is harder to quantify in the practice of daily life). His beliefs seem to be based on simple arithmetic rather than actual human practice. And no, a calorie is probably not the same as another calorie in how the body perceives it. To pretend what, when, and how we eat does not have endrocine potential in our body is simply short sighted.

Doctors need to be upfront with levels of activity an dietary change that will be needed to generate weight loss: 5 hrs of moderate intensity/week. Yes many people will not achieve it, but it misses the point about exercise. Activity promotes the ability to remain active and sloth promotes sloth and weight gain. Just a 100 calories/day excess means weight gain. And the health benefits (unless you do the med diet) from eating simply less is likely much more limited that the benefits from activity.
Henry Greenspan (Michigan)
As the good doc says, the general rubrics--of general utility--need also to be individualized. I lost 45 lbs about 5 years ago, over a period of one year, and have easily kept it off (I am now "normal" for my height). Some of this came from a week-long hospitalization for pneumonia in which a kind of imposed fast caused a quick 6 lb loss (which I sustained). Most has come from a change of diet plus exercise combo. For me personally, and short of radical fasting, doing diet alone is not effective either for losing weight or sustaining what I've already lost. Both are required. And, of course, the additional muscle mass and strength/resilience feels very good. As we say at the pool, different strokes.
Beth Newton (London, Ontario)
I am an overweight marathoner, and I am far from alone!! I found the original article clear and logical and it matches my own experience to some degree. For me and the many other runners I know, running = hunger. I do find though that when I do significant strength training, a lot of my weight melts off, probably a metabolic thing.

I remember Stephen Fry being asked about how he managed a big weight loss once, and his reply was something like, "Prepare to be astonished: I ate less food."
Michael (Los Angeles)
I don't think a half hour of exercise will do much. I work out for an hour on an elliptical 3 days on 1 day off, and I've lost more than 20 lbs in the last 18 months.
ayjaytee (Brooklyn)
I wish you the best of luck. However 18 months is not a long enough period of time. Check back in five years or ten years.
Michael (Los Angeles)
I've been exercising this much for the last 10 years. I just let myself get indulgent with eating, and decided to get back to the recommended BMI, which i pretty much have. And I've still eaten a ton of food while losing the 20 pounds, about 3000 calories a day. So exercise really works. But I'm still relatively young.
lydia davies (allentown)
You will regret that indulgent eating habit, mark my words.
MarieL (Boston)
As a person who has closely monitored her weight for the last 40 years, and kept records, I can attest that calorie-counting has been far more effective than stair-climbing for shedding pounds. I know exercise is good for me, and I try to do it regularly, but I do it to keep my bones strong and my blood pressure down, not to keep weight off. Exercise makes me hungry and hunger makes me eat.
Susan (California)
This reply was nothing short of excellent. Eat for calorie density and weight issues become very minimal. Exercise well for your brain and muscles and bones. I like this guy!!!
David Chase (Boston, MA)
I find that I can move my set point by varying the amount of exercise, but that's about it. Going from zero to 50 miles on a bike per week nine years ago moved it about 15 pounds down, maybe 20 (from 235-240 to 220). Going from 50 to 100 moves it another 5 pounds down, but I get ravenously hungry and it comes right back as soon as the mileage returns to 50. This is all commuting and other utility cycling; every day, not too hard, but not too easy, either.

It is, however, great for my back, joints, and flexibility, great for my blood chemistry, and I shovel snow like a machine: https://vimeo.com/118549278
Paul Richardson (Los Alamos, NM)
I agree that a large majority of people will not make exercise a priority in their lives. I don't think it's because they 'cant' due to physical disability, or because they're single parents with three jobs, it's a 'lifestyle' choice they make for different reasons, maybe because they are brought up to avoid sweat and pain, who knows. People don't seem to have problems adopting new tech gadgets and making a time priority for them. As an everyday runner for 20+ years I know how hard it is to maintain focus on running through injuries, weather, and changes in life; but it's not impossible. It's only recently that people in developed countries didn't need physical effort just to exist. People wouldn't have survived our history to have a 'lifestyle' without physical effort. So, yes eat less more healthy food to help control your weight but don't fool yourself into thinking you don't need, can't make time for, can't change your 'lifestyle' to make a time priority for moderate exercise.
Frequent Flier (USA)
My mother believed that exercise wasn't "ladylike." That attitude is so very hard to deal with, especially for youngsters, and creates life-long bad habits.
gfd1 (Yucca Valley, CA)
Sad that there was so much need for clarification on what was a very understandable first article.
pups (New York, NY)
Just out of curiosity, what about the studies that people who fidget are slim.
That is, people who can't sit still, tap their feet and so on. The are burning cLories as they "rest".
Then there is the treadmill desk where people walk slowly while they work. Susan Orlean, in her article in The New Yorker, lost weight over a year.
Keith (TN)
Thanks for writing the article...I think eating habits are the key to maintaining a healthy weight. A lot of exercises people do (short time period or low intensity) don't really burn that many calories and make you hungrier or feel that you should be hungrier and there is a real risk of overcompensating.
FriedrichN (CA)
Food addiction may play a role in rising obesity. Over the last several decades the sellers of fast food and snacks learned how to combine sugar, salt and fat into extremely profitable addictive drugs that look like food. The correlation with rising obesity is obvious. As with cigarettes, alcohol and many other drugs, once the junk-food habit begins, it is hard to stop. It is virtually impossible to compensate with exercise. Of course, individual reason and will-power play a role. However, junk-food marketing is literally the 500 pound elephant in this room.
Gwen Powell (Minnesota)
So, yes. I agree with you on this. I have lost over 100 lbs and kept most of it off for over three years. I did this largely through diet (Weight Watchers, if you are interested). However, I did find that exercise helped quite a lot with the weight loss, especially once I started doing strength training. I wanted to be able to run, you see, and I weighed too much for it to be healthy on my joints without strengthening them. I lost about 20 lbs in 3 months, I think, and even when I stopped running, I feel like I lost at a faster rate than when I was not exercising before. There is some research that shows that strength training boosts metabolism noticeably, and continues to keep it boosted for up to 36 hours! This makes sense to me because increased muscle mass requires more calories. I'm wondering what the research says about different kinds of exercise in conjunction with diet control. My experience has taught me that when I am not exercising I weigh less but am more flabby. I started strength training again recently because pounds have been creeping (I'm almost 30 now!) and have gained weight and gotten bigger in the shoulders and arms, so I'm really curious what research says about diet and exercise when paired. Can you make more comments about whether my experience might have some credibility and what the takeaway for people struggling with their weight might be?
sew quik (Baltimore, MD)
The author could not be more correct. The enraged comments that erupted over his original article reflect our love of food, and our love of chastising others over not exercising enough. More exercise will NEVER beat more food, as he explained in his original article. If you look through the comments, they are largely anecdotal about what worked for the commentor.

A funny thing happened in our office last year that this article echoes. My surgery scheduler dragged out an old typewritten document (probably from the 50's or 60's) that was given to patients who were told that they had to lose weight before their surgery to lower the risk of complications especially abdominal wall breakdown and wound infections. The document laid out 3 balanced meals a day for 7 days and was made of common foods (toast, eggs, meat, vegetables, etc.). There was no fasting and no exercise proscribed. At the bottom it said that this plan would result in 1-2 pounds per week of weight loss if followed. This allowed the surgical scheduler to schedule surgery based on this rate of weight loss. We added up the calories using online tools and the calories were about 1200-1500 per day. Thus we knew all about weight loss long ago, and we (and the agricultural-industrial-fast-food complex) chose to ignore, forget and obfuscate with nonsense about exercise, Atkins, good vs. bad calories, etc.
TheStar (AZ)
Plenty of people their bodies can stay even at 1500 cals--no, they are not "cheating."
The Pooch (Wendell, MA)
Lots of people lose weight with ease on Atkins-type diets, because they simply feel less hungry. When the body is receiving adequate _nutrients_, including protein and fat, hunger is down-regulated. In contrast, a diet of refined carbs stimulates more hunger, because no real nutrition has been delivered.
Frequent Flier (USA)
Of course, but it's practically impossible to stay on a diet like this long enough to lose any weight.
jeff (earth)
Although obese I thought my significant weight lifting was building lots of muscle that would burn calories. Then I had a body composition analysis and was told that I had on average 40% more muscle than the average man my height and age but when I did the math I saw that the extra muscle accounted for a scant 11 1/2 pounds of my overall 245.
Seymoza (MI)
Yes, I'd say that weight lifting in general is not great for weight loss. All the data is for cardio. Dietary restraint AND cardio is important.
The Pooch (Wendell, MA)
Weightlifting often leads to weight gain, but the weight gained is muscle. More muscle generally means greater health, and can lead to _fat_ loss down the road as all that metabolically active muscle is used.
Marvin Israel (Pennsylvania)
I rarely eat out, cook all my food from scratch (with the exception of canned tomatoes), eat mostly plant-based, but some meat every couple of weeks and some fish and some eggs each week and non-fat plain Greek yogurt. I use about 6 tsp of sugar daily because I can't or am unwilling to eliminate my craving for something sweet. I do a moderate amount of exercise--about 40 miles a week of riding a recumbent trike and weight lifting once a week and some gardening. I weigh 185 lbs at a height of 5'6" which is at least 30 lbs overweight. Why? Because I eat too much and I'm not willing to undergo the mental suffering entailed by cutting the quantity of my meals. I'm in my late 70's; my blood pressure is normal as is blood glucose and cholesterol is held in check by a minimum dose of Lipitor (10 mg).

What is my point? You can eat healthfully and do a moderate amount of exercise and still be significantly overweight if you don't cut your portions, and cutting your portions does not come without mental pain.
Dave Smith (Canada)
As a well-experienced personal trainer, I just want to defend some of the author's comments. Saying that 7 days of weekly exercises is "unsustainable" is so true for the vast majority of the population, especially those who are just starting out with hopes of losing weight.

He is spot on when he says, "What you eat is more important to achieving a healthy weight than how much you exercise." - In fact, I find it impossible to argue this point! (and that's coming from someone who makes a living by teaching people to exercise!)

On my blog (see http://makeyourbodywork.com ) I break down how I help clients lose weight and exercise is a distant 4th in priority! I still love exercise, and know it's important for many health reasons, but it just isn't very effective for stimulating weight-loss.

Great article - sorry to hear you've taken so flak for your comments. This message is long-overdue.
Robert Danley (NJ)
I'm old enough now to have lived through and witnessed the huge increase in obesity our country has experienced. As a child in the 50s, obese chidlren were so rare that they were teased about it. Back then eating habits were much different. As kids we didn't drink soda, eat pizza regularly or eat snack foods. There was no snack time in school, it was expected that children could make it between breakfast and lunch and between lunch and dinner withour eating. There were no MacDonalds and a burger at a roadside stop was a real treat. The increase in obesity is, in my view, entirely due to the change in our eating habits. Lack of exercise may contribute but it is a secondary factor.
pdxtran (Minneapolis)
I'm probably of a similar age, and when I was in kindergarten and first grade, the standard mid morning snack was a half pint of milk and one graham cracker. The graham cracker was eliminated when we reached second grade, because, as the teacher explained, we were old enough to get through the morning without any food between breakfast and lunch. We also walked home for lunch and back, which for me was a distance of five blocks each way, so between all the back-and-forth journeys, I walked 20 blocks five days a week, and no one thought it was unusual.
We rarely ate sweets except for birthdays and holidays and our family's "Friday night treat," which was often popcorn.
As an adult, I can see that I have inherited my shape and fat and muscle patterns from my ancestors, but I never really gained weight until I moved to a car-dependent city. In the 15 years since I have gone up two clothing sizes, despite eating almost no junk food and taking exercise classes three to five times a week.
After adjusting for social class (poor people have less access to high-quality food), I wonder if there is a difference in average weight between urban children, who have a lot of walking built into their daily routine, and suburban children, who can hardly go anywhere without being strapped into a car.
Gwen Powell (Minnesota)
I'm not sure this is a good anecdote, though. Your metabolism was doubtless much higher burning when you were younger, so moving to a car-based city (though I'd say Minneapolis is pretty pedestrian and bike friendly!) probably accounts for less than you'd think. If your eating habits haven't changed and you're over 30, you are probably eating too much. You just don't burn as much as you get older because your muscle mass decreases without very careful training. The lack of walking might account for some small part of that, but likely the biggest difference is that you got older.
Frank (Oz)
recently in France I was surprised that the average local was so skinny they'd be called anorexic in Oz - eating habits apparently no snacking between meals, and sit up at the table and eat politely with the family.

yes - junk food - mostly sugar - profiting junk food corporations.

Eat food - not too much - mostly plants - is a simple guide largely drowned out by junk food ads bombarding us from all sides - and once we start the metabolic syndrome - with sugar hits causing cravings a short time afterwards - it's a slippery slope to fat city.
Lilach Neu (Israel)
I have been struggleing with weight all my life. As an obese child to thin parents, I have never had the fortune to be full on very little. Add to that the cravings for high density food and what you get is a recipe for disaster. My parents encouraged me to do sports, but it has taken me the better part of my life to realize what you wrote in a few lines: exercise, while beneficial, cannot offset unhealthy eating. I enjoy my exercise very much - but I still need to struggle with food - both quantity and quality - each and every day. When overweight people are bullied for their "bad" habits, it just shows so much ignorance on how complex and frustrating this process is.