A couple of weeks ago, Time magazine published an issue with an attention-grabbing headline: Why Exercise Won't Make You Thin.
Won't make me thin? you ask. Then what the heck am I bothering huffing and puffing and sweating like mad on the treadmill?
Good question, says the author, John Cloud. The theory, he writes, is that exercise makes people hungry. And because people eat when they are hungry, they gain weight (duh). People also tend to think they burn more calories than they actually do when they work out, so they "treat" themselves with a Starbucks frappuccino or a dessert, effectively rendering their caloric burn-off null and void or adding on top of what they already eat. Of course, exercise has its benefits, Cloud states, helping with heart disease and overall fitness. But despite the fact that, reported by the Minnesota Heart Survey, that there are more people exercising today than in 1980, yet obesity has risen. What gives?
Well, according to some leading experts, that hypothesis may not be entirely true - or at least true up to a point. James Pivarnik, not an expert in diabetes but the President of American College of Sports Medicine in Indianapolis, wrote a rebuttle in the following [Aug. 17] issue, stating:
"I must take issue with some of the points portrayed as fact. Numerous studies have shown that exercise is indeed central to an effective weight-loss program. The key concept is a simple equation of energy balance: calories expended throughout the day must exceed calories consumed as food. And contrary to the data selected for your article, studies have shown that most exercisers are not uncontrollably hungry after a workout. We strongly encourage reporting that portrays both sides of an issue so readers can decide for themselves--instead of being led down a potentially harmful path."
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The LA Times also has great counterpoints, with one expert, American College of Sports Medicine member Dr. Janet Rankin, stating, "A practical response to the claim that exercise makes you eat more and gain weight is to look around. If this were the case, wouldn't those who regularly exercise be the fattest? Obviously, that isn't the case."
It's true that many different factors go into whether or not someone is successful at losing weight. There's commitment, there's the right type of exercise, there's intensity level and length of time, and there's what you do when you're not exercising (like eating). Dieting and exercise are important for weight loss, and exercise is certainly important for weight maintenance. But for people with diabetes, who are so consumed with balancing food, medication, exercise and, well... life, things are not nearly as simple as it is for our non-PWD counterparts. So I thought I'd ask some leading experts in the field of diabetes and exercise to weigh in on what they think of these claims and what we can do about it:
Sheri Colberg-Ochs, a specialist in diabetes and exercise physiology and author of The Diabetic Athlete, says, "It's common sense that you can easily overeat and overbalance the calories you expend during exercise IF you pay no attention to your diet at all."
Cloud theorizes that many people aren't able to lose weight because exercise makes them ravenous afterwards. But it's more likely that for most people, it's not an overwhelming sense of hunger that drives people to eat, but this "reward" concept — that people feel entitled to eat whatever they want since they worked out. Sheri says most people generally expend about 300-600 calories per hour of aerobic work. "You can eat more than that in a peanut butter sandwich or a small order of French fries," she says. So the idea of rewarding workouts with a post-meal "snack" has got to go, folks.
For people with type 1, we sometimes have to eat before/during/after a workout to keep our blood sugar stable, which can sometimes effectively kill off the exercise calorie burn, for example when we're forced to gulp down a juice box.
"For type 1s, you have to cut back on your insulin if you don't want to chase lows all the time," Sheri says, adding that you may indeed need to eat carbs and protein after exercise to prevent later-onset lows. Not a treat, but a necessity. She adds that there are lower calorie ways of treating a hypo, by using glucose tablets, gels or liquids instead of something like juice. Treating with glucose tablets or boxed juice can also prevent accidental over-treating, which piles on the calories from the uncontrollable urge to eat out your refrigerator!
Gary Scheiner, CDE, author of Think Like a Pancreas, and a board member of the Diabetes Exercise and Sports Association, adds: "Cut the insulin that is active during, and potentially for a while after, the workout. This is easier and more effective when exercise is performed soon after a meal. Exercise before a meal usually requires extra carbohydrate consumption, which contributes to weight gain, while exercise after meals allows a substantial insulin dose reduction, which contributes to weight loss."
There's the trick: It's all about balance. According to Sheri, research shows that you can lose weight through exercise alone, but it may take more like an hour each day, as well as monitoring your food intake. Losing weight through dieting alone is tough, though. "You end up losing a lot of muscle mass and not just fat, which leaves you with less muscle and a lower metabolic rate when you're done," Sheri says.
A lower metabolic rate means you're burning fat much slower — not something you want to encourage if you're trying to lose weight! The key is to exercise regularly AND watch your diet. No extra snacks, and monitor your blood sugar and make adjustments with your doctor to work on low blood sugars.
Gary, a PWD for 24 years himself, adds this final note: "I think that there is too much obsession with the scale. 'Fitness' is what we're striving for, and that is not always reflected when weighing ourselves. Many forms of exercise will increase muscle mass, bone density and blood volume — all of which may hinder weight loss, but they all reflect improved fitness. Loss of body fat (the 'bad stuff') with a concurrent gain in the 'good stuff' usually shows up in things like how your clothes fit, waist-hip ratio, and body fat percentage... but not on a simple weigh-in."
It might be easy to blame exercise for the fact that you're not losing weight, and therefore think that you shouldn't exercise at all. But this is just plain nonsense; exercise has myriad positive benefits on your health, helping to prevent dozens of diseases and health conditions, like high blood pressure and heart disease. Let's get sensible here, Mr. Cloud: Exercise should be done IN ADDITION to healthy eating (in moderation), not as a substitute.