Why Weight Loss is Out and Body Recomp is In

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From my work in obesity medicine at UCLA’s weight loss clinic, where we see about 140 people on a Saturday morning, I answer questions all the time about weight loss goals, what’s an ideal body weight, and the targeted strategies to reach these goals. My favorites are the frustrating questions about why the numbers on a scale aren’t moving in the expected direction, despite following every detail in the program. I love this one, because it really shows the difference in outcomes.

In one example, there’s someone who’s kind of, sort of doing the nutrition component of the program, maybe not fully meeting their protein goals, and rarely engaging in fitness. The scale looks like it’s going ok, with the pounds coming off. However, we then take a look at their body composition numbers and it’s a whole different story. Those -10 pounds are coming primarily from muscle loss, and only a couple pounds from fat mass loss. That’s just a terrible situation. Not only have you lost lean muscle tissue that helps keep up your basal metabolic rate, it’s also likely that the weight will come back on if you go back to the eating habits from the past. It’s not a good outcome, but a great teachable point in the program.

On the other side of the spectrum we have those who are getting super frustrated, even though they’ve been following the calorie and nutrition guidelines, have been meeting the exercise goals and even adding in the resistance training a couple of times per week. But the scale has barely budged. How, after all this time and effort, does it not show in the numbers? Then we evaluate the body composition findings and see the gold medal results. Those -5 pounds are coming from a loss of 5 pounds of fat mass and a preservation of the lean muscle tissue. By preserving that basal metabolic rate with the lean tissue, they are in a much better position to keep that weight off for good.

The key here is that these are long-term wins. Enhancing the amount of muscle takes longer with caloric restriction, which is why Body Recomp isn’t part of the fad quick weight loss ads. No thanks to skinny fat and a subpar fat-to-muscle ratio, which is definitely not a good strategy for your health and hormones. It’s definitely worth it for the long-term, as it means you’re combining the right nutrition program with smart strength and conditioning workouts. So good that the data shows a 23% reduced mortality from all causes from just 2 or more training sessions a week. Maybe it’s related to the protective effect of skeletal muscle on cardiometabolic disease. I’ll take that.

References:

Emmanuel Stamatakis, I -Min Lee, Jason Bennie, Jonathan Freeston, Mark Hamer, Gary O’Donovan, Ding Ding, Adrian Bauman, Yorgi Mavros, Does Strength-Promoting Exercise Confer Unique Health Benefits? A Pooled Analysis of Data on 11 Population Cohorts With All-Cause, Cancer, and Cardiovascular Mortality Endpoints, American Journal of Epidemiology, Volume 187, Issue 5, May 2018, Pages 1102–1112

Kim Y., Han B.-D., Han K., Shin K.E., Lee H., Kim T.R., Cho K.H., Kim D.H., Kim Y.H., Kim H., et al. Optimal cutoffs for low skeletal muscle mass related to cardiovascular risk in adults: The Korea National Health and Nutrition Examination Survey 2009–2010. Endocrine. 2015;50:424–433.

Ramírez-Vélez, Robinson, et al. "Fat-to-muscle ratio: A new anthropometric indicator as a screening tool for metabolic syndrome in young colombian people." Nutrients 10.8 (2018): 1027.

Srikanthan P., Karlamangla A.S. Relative Muscle Mass Is Inversely Associated with Insulin Resistance and Prediabetes. Findings from the Third National Health and Nutrition Examination Survey. J. Clin. Endocrinol. Metab. 2011;96:2898–2903.

Xu K., Zhu H.J., Chen S., Chen L., Wang X., Zhang L.Y., Pan L., Wang L., Feng K., Wang K., et al. Fat-to-muscle Ratio: A New Anthropometric Indicator for Predicting Metabolic Syndrome in the Han and Bouyei Populations from Guizhou Province, China. Biomed. Environ. Sci. 2018;31:261–271.