[Mohr Results]

Hey Folks:

My entire PhD focus was on the prevention and treatment of overweight and obesity. Look at the scientific weight loss literature and the recommendation is a 1200-1800 calorie diet (depending on starting body weight). Yes, you will lose muscle mass...but at 400 lbs, the goal is to get weight off. Of course you want to preserve as much muscle mass as possible, but with this population, they need to do some type of aerobic exercise because calorie for calorie, you'll have the most success. Resistance training is of course fantastic as a form of exercise, but I want to jump out a window when folks tell me they (or their clients) are replacing fat with muscle, so the scale is not moving. No offense, but a person isn't going to have 400 lbs of lean body mass when all is said and done, so they need to get fat (and lots of it) off the body. And, the amount of weight or movements they can do will be very limited, so building muscle is not going to be that easy. The other misconception is that you can preserve your metabolic rate with resistance training--I wanted this to be true for the longest time, however, as I learned more and more about this population and read the science, I realized that because your overall body is smaller (for example 400 lbs to 300 lbs), your metabolic rate will be lower. Even if it is all fat weight, it's still a large amount of body mass and that means your metabolic rate will drop. As we all know, it's not easy to put on muscle when working out hard, so I'm not sure why folks think in the obese population they can pack on slabs of muscle quickly to preserve the drop in metabolic rate. There are some data to show a mild preservation of RMR with resistance training, but it will still go down overtime, which is why you need that calorie deficit coupled with exercise. Overtime, as folks become more able to exercise (I have worked with people who literally are maxed out with heart rates through the roof after 1 minute of walking at 3 mph), then you can add different exercise modalities as they adopt. With an obese population, it seems that resistance training may be most useful for getting them to do more activities of daily living (getting out of chairs so they can walk across the room, etc). Alright, I'll now step down off my soap box.