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August 2004 Issue
The classic weight control dilemma: diet or exercise?
by Michael Fick
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Medically damaging, life-shortening excess weight is epidemic in the U.S. If you've followed this column for a few years, you know the solutions: fewer calories and more exercise. You know how and why to change your diet and exercise regimens, and how to free up time to make those changes. What we haven't discussed here is the classic diet vs. exercise dilemma: which one provides more important, effective weight and health management? Which is the first ingredient listed on the fountain of youth nutrition label, diet (your eating habits, not some canned or printed "Diet" named after the latest guru) or exercise?

Of course, the best approach is obvious: a good, sound, 24/7 eating routine plus a few hours of hard aerobic and strength-building exercises several days each week. Most of the people who achieve this found exercise they love (kids from 4 to 104 call it play) and modified their lifestyles, often even their careers, to allow or even involve their play. Few people are willing to go this far, though; the rest do nothing or compromise with a mixed bag of lifestyle changes. But where do we start?

Many overweight people coast for much of the year, then diet to lose weight for events, such as a reunion, their wedding, or bikini season. Bad idea, on several counts:

  • They're still laying down damage most of the year.

  • Rapid weight loss by calorie deprivation lowers our metabolism, making it even tougher to keep the weight off.

  • Calorie deprivation makes us hungry (exercise doesn't increase appetite much) and dooms us to relapses.

  • Our bodies "remember" weight yo-yos and fight each year's bikini blitz a little harder.

  • Quick, early weight loss with most diets, such as the low-carb fad, is primarily water loss, not likely to last through the honeymoon, let alone the whole bikini season. It lets the remaining excess fat continue to do harm, and may do its own damage.

  • They're still couch potatoes under the skin. Lookin' good once a year is just a band-aid on a sprained ankle, a fancy wrapping on a brown Christmas necktie. While it may soothe one's vanity for a party or a season, it does little for health or longevity. Sedentary thin people are not necessarily healthy.

  • Calorie -- especially carb -- deprivation, whether for a week while carb-depriving for a marathon, for a bikini season, or for a whole tortured life, leaves us hungry and grouchy.

  • Starvation is for runway models, whose shapes turn most guys' stomachs, not their heads.
Diet alone can shed weight, but the ketosis induced by starvation diets in general or rigorous low-carb diets in particular can consume muscle and ultimately even vital organ tissue. (For a visual image of ketosis carried to extremes, think "concentration camps".) People relying on diet alone for weight control, especially if they've ever been overweight, are just a binge away from a fat attack and are generally less healthy and shorter-lived than lifelong exercisers. Dieting is just too freakin' hard, takes too much discipline, is no fun, and lacks the instant gratification our culture demands, to work for many people.
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