Better Health: Smart Health Commentary Better Health (TM): smart health commentary

Latest Posts

Is Extreme Dieting And Exercise Worth It? My Personal Journey – With Photos

Dr. Val "After" Photo #1

I just completed 8 weeks of what I’d call “extreme dieting and exercise.” I don’t mean dangerous starvation and constant exercise, I mean the hardest “medically safe” amount of diet and exercise possible. It involved about 3 hours of exercise per day (6 days/wk), along with a calorie-restricted diet of 1500 calories/day (no refined carbs, only healthy fats, relatively high protein). My exercise consisted of heavy weight lifting, kettle bell sets, kickboxing, and sprints on the bike, summit trainer, and on an outdoor track, with long walks each afternoon. Trust me when I say – I pushed myself to the very limits of what my body could handle without becoming sick or injured. I did this with the help of my dear friend and trainer Meredith Deckert.

Why on earth would I do something so extreme? Well, first of all, I wanted the “right to bare arms” on my wedding day. I just woke up and realized I was getting married in 8 weeks and that I’d have photos of the event memorialized for my future kids and grand kids… so the “bat wings” had to go (you know what I’m talking about, ladies), and the time till “lift off” was pretty short – hence the need for maximum effort.

Secondly, I was scientifically curious to know what a “best case scenario,” two month, physique optimization strategy might produce. I knew I wouldn’t cheat on the diet or fall off the exercise wagon, so at least I could be sure that results were based upon strict adherence. Self-reports of diet and exercise regimens are notoriously inaccurate, so this doubting Thomas had to see for herself! (Of course n=1 in this experiment and won’t correlate exactly with others’ experiences due to differences in starting fitness, body fat, age, genetics and gender).

And Thirdly, I wanted to experience (first hand) what is possible so that I could empathize with my patients who were trying to lose weight, and provide personal anecdotes of encouragement. Since America’s biggest health challenge (pun intended) is obesity, I feel obliged to do my part to model lean living. Otherwise, what right do I have to teach others what to do? (Note that heavier physicians are less likely to educate overweight patients about weight loss).

So what did I learn? Each of these probably merits its own blog post, so I’ll summarize briefly and dig into the details with you soon…

1. Calorie math doesn’t necessarily work with the bathroom scale. We’ve all heard that a pound of fat equals 3,500 calories, so that if you decrease your calorie intake (or increase your calorie burn) by that much, you WILL lose a pound on the scale. That has not been my experience (I lost an average of only 30% of what the scale should have shown based on the math). I have some theories as to why that might be (which I’ll share later), but suffice it to say that if you are “doing everything right” and the scale is not rewarding you – take heart!

2. Weight training improves how you look MUCH more effectively than cardio. Before my extreme diet, I was running 1/2 marathons and spending hours on the spin bike. I was in excellent cardiovascular shape, but I had a relatively high percent body fat (about 30%) and I was certainly not getting “skinny” from all the running. I was actually losing muscle and looking softer and more “out of shape.” Dialing down the cardio and increasing the weight training had a rapid, visible impact on how athletic I looked.

3. Your leaner self may not look the way you think it will. When I first began my weight loss journey, I imagined that I would slowly melt away all the excess fat to reveal a lovely ballerina inside. What I found was that after the fat was gone, I wasn’t a ballerina at all. I looked a lot more like a wrestler! People really have different genetically determined body types – and no amount of diet and exercise will make us look like someone else. We’ll just look like our best selves, which is ok! Don’t fall into the trap of thinking that success only looks like a Sports Illustrated swimsuit model. After all, Olympic athletes all have very different bodies, and are at the top of their respective games! (This fun, height and weight database shows how you compare to recent Olympians.)

4. Clothing size is the most helpful measure of success. After 2 months of intense diet and exercise the scale only changed by about 6 lbs. The body impedance analyzer told a little different story (the InBody 520 estimated that I had lost about 10 lbs of fat and gained 5 lbs of muscle with an overall percent body fat loss of about 4%.) But the truth is, that nothing measured my success as well as clothing. I dropped nearly two dress sizes and had to buy a new wedding dress a week before the event!  So if your scale isn’t showing you love, what are your jeans saying? Listen to them.

Conclusion: In my experience, the best a slightly overweight, middle aged woman can do (safely) in 8 weeks is lose 10 lbs of pure fat and gain 5 lbs of muscle. It is extremely difficult to achieve that much, and I would highly recommend doing it over a longer period of time. Is the pain worth the effort? Here are my “before” and “after” photos. What do you think?

Before: (151 lbs)

After (145 lbs):

Help! My Diet Is So Gross. Do I Have To Do It This Way? Insights Welcome!

I’m feeling rather nauseated today. This is my fifth day of a high-protein, low-fat, low-carb diet, and I have already developed a deep-seated hatred of egg whites. My regimen includes uncomfortable quantities of grilled chicken breast, fat-free cottage cheese, Greek yogurt, and egg protein, occasionally garnished with a lettuce leaf or perhaps a blueberry. Just yesterday I had to drink a plastic test tube of liquid protein to meet my goals (see offending product image to the left). It looked like a blood-tinged albumin sample, and tasted like orange flavor crystals with a splash of soy sauce.

I know that the scientific literature (if we distill it and perhaps oversimplify it a bit) seems to suggest that there may be a short-term advantage to high-protein diets in terms of weight loss, but that this advantage fades after a year. Yet almost every trainer and athlete I’ve encountered keeps telling me that the only way to get “really lean” is to eat unimaginable amounts of protein, avoid refined carbs, dramatically limit the complex carbs, and dial down the fat intake. Essentially, I must be reduced to swilling test tubes of orange-soy “albumin.”

When I strenuously protested the diet plan presented to me by my trainer, she simply said, “If you care what food tastes like then you’re not serious about losing fat.”

“Well how long do I need to consume 50% of my calories as protein?” I asked meekly, assuming that there would be an end point in sight. Read more »

Weight Loss Tips For ABC News

The weather is heating up, and soon most of us will be back in shorts and t-shirts…  and worrying about looking good in our dreaded bathing suits. I had the opportunity to offer some evidence-based weight loss and fitness tips to ABC News in Washington, DC. You can view the clip or read my summary below:

Read more »

Dr. Val Offers ABC News Secrets To Long-Term Weight Loss

Dr. Jim Hill is a friend of mine and co-developer of the National Weight Control Registry – the nation’s largest database of individuals who have lost at least 30 pounds and kept off the weight for at least 1 year. Jim has been studying their commonalities – and has determined that there is in fact a recipe for long-term weight loss success. I shared the recipe with ABC news today. My interviewer (Natasha Barrett) was really funny, and had tendencies to blurt questions in the middle of our conversation (such as: “what do you think of granola bars?”)

Latest Interviews

IDEA Labs: Medical Students Take The Lead In Healthcare Innovation

It’s no secret that doctors are disappointed with the way that the U.S. healthcare system is evolving. Most feel helpless about improving their work conditions or solving technical problems in patient care. Fortunately one young medical student was undeterred by the mountain of disappointment carried by his senior clinician mentors…

Read more »

How To Be A Successful Patient: Young Doctors Offer Some Advice

I am proud to be a part of the American Resident Project an initiative that promotes the writing of medical students residents and new physicians as they explore ideas for transforming American health care delivery. I recently had the opportunity to interview three of the writing fellows about how to…

Read more »

See all interviews »

Latest Cartoon

See all cartoons »

Latest Book Reviews

Book Review: Is Empathy Learned By Faking It Till It’s Real?

I m often asked to do book reviews on my blog and I rarely agree to them. This is because it takes me a long time to read a book and then if I don t enjoy it I figure the author would rather me remain silent than publish my…

Read more »

The Spirit Of The Place: Samuel Shem’s New Book May Depress You

When I was in medical school I read Samuel Shem s House Of God as a right of passage. At the time I found it to be a cynical yet eerily accurate portrayal of the underbelly of academic medicine. I gained comfort from its gallows humor and it made me…

Read more »

Eat To Save Your Life: Another Half-True Diet Book

I am hesitant to review diet books because they are so often a tangled mess of fact and fiction. Teasing out their truth from falsehood is about as exhausting as delousing a long-haired elementary school student. However after being approached by the authors’ PR agency with the promise of a…

Read more »

See all book reviews »