There’s one point, though, that’s impossible to argue: heavy people who improve their lifestyle are almost certainly better off, even if they never drop a pound. In a 2007 paper in the Canadian Journal of Cardiology, obesity expert Robert Ross and co-author Peter Janiszewski argued for the importance of exercise, whether it contributes to weight loss or not. Physical activity reduces waist size and visceral fat deposits, even if a person’s weight stays the same; it has a host of other positive effects, too. In a new study from the University of Illinois, just modest amounts of exercise—even without a change in diet—were shown to confer benefits, including less fat in the liver and better insulin sensitivity. “Exercise is medicine, period,” says Ross, a professor at Queen’s University. “You become physically active, and you reduce your risk for almost any disease on the planet.”
Diet, too, is crucial. “By definition, a healthy diet is something you can follow for life,” he says. The same is true of any exercise program. “This is a lifestyle-based disease,” Ross says. “The question is, how do we treat it with lifestyle?”
Obesity expert Jean-Pierre Després, a professor at Université Laval and scientific director of the International Chair on Cardiometabolic Risk, has been trying to do just that. In a recently completed study, Després and his team followed 144 viscerally obese men who, over the course of three years, met regularly with a nutritionist and kinesiologist. Diet and exercise programs were negotiated with individual subjects, and tailor-made to fit their lifestyles: “If the patient drinks four cans of Coke a day, we say, let’s cut that by half,” he offers. Their exercise preferences were taken into account, too. “The key point was to be flexible,” Després says.
Results were remarkable: the men succeeded in losing large amounts of visceral fat from the waistline, even when they didn’t drop a significant number of pounds. They showed a marked improvement in risk factors for diabetes and cardiovascular disease, suggesting that losing visceral fat, not achieving a “healthy weight,” should be the clinical goal.
The obesity crisis may be more nuanced than we ever imagined. Its most effective treatment, though, still seems to be the most basic of all. “When you exercise and eat a balanced diet,” says Ross, “you’re taking the best medicine we have.”
Pages: 1 2
