Unfiltered Weight Loss Questions Answered

Jim Hill:

Welcome to Weight Loss And, where we delve into the world of weight loss. I'm Jim Hill.

Holly Wyatt:

And I'm Holly Wyatt. We're both dedicated to helping you lose weight, keep it off, and live your best life while you're doing it.

Jim Hill:

Indeed, we now realize successful weight loss combines the science and art of medicine, knowing what to do and why you will do it.

Holly Wyatt:

Yes, the “And” allows us to talk about all the other stuff that makes your journey so much bigger, better, and exciting.

Jim Hill:

Ready for the “And” factor?

Holly Wyatt:

Let's dive in.

Jim Hill:

Here we go. Holly, today we're doing something a little different. Actually, it's a lot different. Instead of diving into a single topic, we're answering the real questions. Whoa, the real questions people have about weight loss, the ones they're too afraid to ask out loud. This should be fun.

Holly Wyatt:

Yeah. And let me tell you, Jim, I've taken a look at these. These questions are good. And some of them, I have to admit, are a little awkward. Some are things people think they should already know, but maybe are scared to ask. But they ask us these questions. And others, you know, are just some questions that I think are confusing because of all the mixed messages out there. But here's the thing. If you're wondering about it, if you're out there thinking, I have a question about it, I'm wondering about it, chances are there are thousands of other people. Thinking the same thing. So I always say, don't be scared to ask a question. And today we're going to give the real science-backed, no- BS. I don't know if I can even say that, but I'm going to say it. I'm going to say no BS answers to some of these questions.

Jim Hill:

That's right, Holly. Weight loss is full of contradictions. One expert says don't eat carbs. Another one says eat lots of carbs. You need them for energy. Some people swear by things like intermittent fasting, why others say frequency of eating boosts metabolism. If you look at everything out there, it's no wonder people feel stuck.

Holly Wyatt:

Don't even get me started about the clickbait headlines that say, you know, lose 10 pounds in two days or, you know, do this weird thing and you'll melt all your belly fat away while you sleep. I mean, it's just crazy and it's exhausting. But today we're going to try to set the record straight on some of these.

Jim Hill:

Yeah, we're going to cut through the noise and break down the most common weight loss myths, confusions, and tough questions. So hopefully you walk away with real, actionable answers.

Holly Wyatt:

And we're not going to hold back. Not that we hold back, but...

Jim Hill:

When have we ever held back?

Holly Wyatt:

I know. We're going to talk about everything from why weight loss slows down to even there's even a sex question in there, Jim.

Jim Hill:

I'm ready for that one, Holly.

Holly Wyatt:

Are you ready for the sex question? And then we're going to talk about, of course, some of the weight loss medications. Always lots of questions about that. Are they the magic bullet? And, oh, and there's an alcohol question.

Jim Hill:

Ooh, that's a good one.

Holly Wyatt:

That's really hot right now, too. Yeah. So I think these are a lot of things that people will want to know.

Jim Hill:

So if you've ever been frustrated, confused or just plain fed up with the mixed messages out there, this is the episode for you. Stick around, because I promise you some of these answers are going to surprise you.

Holly Wyatt:

All right, I'm ready. Let's dig in.

Jim Hill:

Okay, the first one is, why do I lose weight so fast at first, and then suddenly nothing?

Holly Wyatt:

Yep, the plateau, right? It's going well, especially at the very beginning, and then I'm doing the same things I've been doing. I'm still watching what I'm eating, I'm moving, I'm doing everything, but the scale suddenly stops moving. What is that all about? I think we've done a whole episode on plateauing, Jim, I think.

Jim Hill:

Yeah, but it's a big one because it's something everybody always experiences in weight loss.

Holly Wyatt:

So let's talk a little bit about what's actually happening to your metabolism or what's actually and what's actually happening to your weight when you start to restrict your calories and you start burning fat. The initial weight you lose and it's quick and it's powerful because you feel good. You get on the scale every morning for the first week and it's going down a pound or two pounds a day, it's mostly water. I hate to tell people that, but that's mostly water. And the reason you lose water at the beginning of a diet when you restrict calories is because you restrict carbohydrates usually. And what that really causes you to do is your body to kind of dig in and burn glycogen, which is how your body stores carbohydrates. And when you do that, there's water that's associated with that storage of glycogen. So you lose a lot of water as you burn that glycogen. So you get this kind of quick weight loss at the beginning, but it's not fat loss. It's water loss, but people don't see it because on the scale, you can't tell the difference.

Jim Hill:

Right. The other thing that happens, and we've talked about this before, it relates back to energy balance, Holly, which is my favorite thing. And so let's look at someone. Let's just take an example of, say, someone is eating 3,000 calories a day, and they're overweight, and they're maintaining their weight. So they decide to lose weight. So they go on a diet which gives them, let's say, 1,500 calories a day. So there's a big difference. They're 1,500 calories down, right? So that's negative energy balance. It's going to produce weight loss. But your body adapts. As you lose weight, your energy expenditure goes down. So before it was maybe 3,000 calories. Now it starts to go down. So the difference between the energy you need and the energy you're taking in narrows. So your body adjusts and it's why you don't keep losing weight forever. Your body adjusts and now your energy expenditure will be lowered to your new lowered intake and you will slow or stop weight loss.

Holly Wyatt:

So if your plateau happens after a couple months after you've lost some weight, it's probably that what you just talked about is really happening. You've you've decreased your energy expenditure because you're smaller now and you're not going to burn as many calories. If you're thinking that plateau is happening in the first couple of weeks, I think that's usually more related to the water issue. And if you're, let's just say you're losing a pound of fat a week, which is significant, right? A pound of fat a week is, you're going to see the little bitty changes you see on the scale from losing the fat may be hidden by water fluctuation. So you think you're not losing anything when really you are still burning fat in that beginning section the first few weeks or even months. But then eventually, yes, you can't lose weight forever. We say that the body fights back and it makes sense energetically that plateauing after several months of weight loss is the normal kind of physiology of the body kicking in. But at the beginning, I think people give up and it's all about the water and not understanding that.

Jim Hill:

But plateaus are okay. You want to reach a plateau if you're successful. You want to reach a plateau at some point and then you can decide if you want to lose more weight, you have to change something behaviorally or then you go into weight loss maintenance mode, which is very different.

Holly Wyatt:

Yeah. One of the things I always tell people though, let's not change something too soon.

Jim Hill:

Yeah.

Holly Wyatt:

Because I'll see them, they'll email me and they say they've been, you know, a week and I haven't lost any weight or two weeks and I'm in a plateau. I'm like, no, you're not. We can't say you're in a plateau in one or two weeks. And I don't necessarily want you changing something then. That's too early. But you're right. You get to a true plateau. Then you've got to decide, all right, I'm going to change what I'm eating or I'm going to change my physical activity. I'm going to make some change if I am really in a plateau or time to go into weight loss maintenance.

Jim Hill:

So give it some time because while you may think gets a plateau, there may be things that are happening in your body that aren't measurable just by the scale.

Holly Wyatt:

Yeah. And water, I always say water, you can hold on to a pound, two, three, four, lots of water daily from stress, from travel, from how many hours you sleep affects how much water your body holds onto. So that hides fat loss because fat loss is a little bit each day, but water swings are big so they can hide the fat loss early and then late, it's about, yes, this is physiology. Your body was designed not to lose weight forever. You got to do something different or move into weight loss maintenance. So it's tricky. I can see why this is a confusing area for people.

Jim Hill:

Okay, let's go to our next one, Holly.

Holly Wyatt:

All right.

Jim Hill:

Is it really just about eating less and moving more? Because I feel like I'm doing that and it's not working. This is a good one.

Holly Wyatt:

Oh, this is the one everybody has probably experienced and just frustrated because on one hand, they hear out there, you just need to eat less. You just need to move more. It's all about calories in, calories out. And you feel like you've made some changes in what you're eating and you feel like you've made some changes and you're moving, but yet it's not working. It's not moving. I'm not losing weight.

Jim Hill:

I hear people saying it can't be that simple, as simple as calories in and calories out. Well, let me tell you, that's not simple. At the end of the day, Holly, a calorie is a calorie. Now, I just got a book in the mail yesterday by a good friend and colleague, Dr. Keith Frayn, and it's called A Calorie is a Calorie. And he goes through exactly why calories in and calories out are right. That's the law of thermodynamics. But it's way more complicated than that. If you look at all the things that impact your food intake, all the things that impact your energy expenditure, all the things that affect your metabolism, you begin to see that it isn't simple. A calorie is a calorie, but there are so many things that affect that. For example, the kinds of food you eat, a high-fat diet, a high-carb diet, they're handled differently by your metabolism. So at the end of the day, the laws of thermodynamics work. It's energy in and energy out, but it's not as simple as a lot of people want to make it.

Holly Wyatt:

I think that the statement is true. It is about eating less and moving more, but there's so many factors that impact that. And I think the example that I always give to people so they can kind of get it is, let's say the type of calories you said, the type of calories you eat, what you eat may make a difference. Let's say you eat a diet that maybe is a little bit higher in carbohydrate. And that for some people, not all people, but for some people might stimulate their appetite to want to eat more calories later in the day or the next day. And then, therefore, they're eating more calories. They may not even realize it, but it does that. And so there's how the type of calories you're eating may impact how many calories are coming in, not directly, but indirectly. And there's so many things that I think affect both on the energy intake side and on how many calories you burn on the expenditure side.

Jim Hill:

Well, the other thing too, Holly, it brings up something you and I harp on all the time, the difference between weight loss and weight loss maintenance. And we've said over and over, the way you lose weight is to eat less. Moving more helps a little bit, but let's face it, on the weight loss side, it's eating less. And it works. And that's why virtually every diet out there, you go in the bookstore and you look at all the diet books. They all work to get the weight off because they help you eat less. It's very different when you're trying to keep the weight off because what you and I say is weight loss is about eating less and moving more, but weight loss maintenance is about moving more and eating more. So what we have to understand is food restriction is a short-term tool. It works in getting weight off. It is not a long-term strategy. We have decades of research showing that food restriction is not a good long-term strategy. So eating less and moving more, yes, to get the weight off. But once you're going to keep the weight off, you want to move more and eat more. The people that are successful maintaining their weight loss aren't eating a low-calorie diet. They're actually eating a lot of calories, but they match it by a high level of physical activity and energy expenditure.

Holly Wyatt:

I can think of it kind of energy through the system. I use the term flux, and a lot of people don't understand the word flux, so I'm trying to think of a better word. But you want to run your body at a high level of in and out, right? That's where you maintain the best. And I think that is a message that most people do not understand. They try to do it at a low level of food intake and a low level of energy expenditure. I believe that's not how our body was meant to work optimally.

Jim Hill:

Yeah. Put simply, people eat less and move more. They lose weight. Then they try to keep doing that.

Holly Wyatt:

Yeah.

Jim Hill:

And you can't keep doing it. You get hungry. You cannot food restrict. Our whole physiology was geared toward promoting eating. And food restriction is just something that is very, very difficult to do over the long term.

Holly Wyatt:

The other thing I put down on this question that I wanted to make sure we talked about is, even though it's simple in terms of calories, like that statement, it is so complex because there's so many factors that are involved. And it really comes to the name of our program, Weight Loss And dot, dot, dot.

Jim Hill:

It's the and that's critical.

Holly Wyatt:

Yeah, I mean, timing could be important and we talk about the microbiome. I mean, there's so many different things that can influence the calories in and the calories out that take us something that is a true statement, but makes it complex and many, many different factors. And then add on, that those factors are different for different people, just a whole another layer.

Jim Hill:

But at the end of the day, the only way you're going to lose weight is to take in fewer calories than you burn. There's no other magic way of doing it. And you can only do that for a short period of time. Great strategy for weight loss, not a great strategy to keep weight off.

Holly Wyatt:

Yeah, and it's interesting. We study the weight loss and all the different factors that impact that eating less, not near as much research. We've done some, but not near as much research on that weight loss maintenance period, right? What is influencing that? So that's critical. All right, let's move on. What's the third one on our list?

Jim Hill:

So what's the deal with Ozempic, Wegovy, the GLP-1 meds? Do we have the answer? Is this a secret to staying thin forever?

Holly Wyatt:

I get this question a lot whenever I'm on a show or doing an interview. This is now the big question is, has this really solved the problem? Is it the magic that we've been looking for? I think time will tell, Jim. We don't know for sure. My thoughts on this is it's definitely helping with the weight loss piece, but we still don't have that weight loss maintenance piece figured out yet. And we need more time to see just how impactful. I mean, I think some of the newer data coming out is some of the people are not staying on the drugs. They're on them for a short period of time and then they stop the drug for some reason.

Jim Hill:

Yeah, we've done a few podcasts about this. And you and I welcome these medications. We think they're wonderful new tools, but I would say they're not the total answer. They are wonderful to get weight off. They can produce more weight loss than any programs we've had before, except for surgery. And they're actually approaching the amount of weight loss you get with surgery. So people are losing 20, 25, 30% of their body weight and that's something that didn't happen before. But the key is, okay, now what? Now you get the weight off, now what? So the way these were designed was to be forever drugs. You go on them, you lose weight, you stay on them for a lifetime and keep the weight off.

And again, we have data for maybe four years or so. And it looks like over that period of time, that's what happens. People that continue to take them for four years are able to keep the weight off. But as you said, we're getting more and more data to suggest that not even half the people who start them continue them long term. So there are a lot of reasons and we've done shows on the reasons. There are many reasons why people might not continue on the medications. The other thing we know is when you stop the medications, unless you have a really strong plan, you're going to regain the weight. And that's what's so frustrating to see people lose 20, 25, 30% of their body weight, go off the meds and regain it. So what we need is both a strategy to get people to understand long-term use of these drugs is an option, but we also need some alternatives for people who just don't want to be on the meds, can't tolerate the side effects, etc. So the drugs are wonderful weight loss. Now we need multiple ways of keeping the weight off, one of which is continuing the meds, but we need other strategies for weight loss maintenance.

Holly Wyatt:

Yeah, and I think figuring that out, getting that out there is really going to be important to say, is this a game changer?

Jim Hill:

Yes.

Holly Wyatt:

Because if these drugs just produce weight loss and people regain it, that is not that much of a game changer, in my opinion. But if we can couple it with something else, if we can figure out either keep people on them long term or give them other alternatives, which is what I think we're going to need. I think some people are going to need to or want to come off the drugs. If we don't figure that out, then I don't think it's not going to help us that much.

Jim Hill:

No, I agree. And one of the things that the meds show is the impact of weight loss. If we could produce and maintain weight loss in the population, the health impacts, the chronic disease, it would be a game changer for our whole health care system.

Holly Wyatt:

The other thing I get, I get this question or I get people talking to me about this. There are people who do not lose weight on the drugs. I just had someone who really came to me and say, Holly, I was on max dose and it didn't work for me. And you got to realize we're seeing the percentages. Half the people are losing more than that, but half the people are losing less than that or close to that. So kind of what we're talking about, there still probably needs to be other ways to lose weight, because not everybody will be successful on a weight loss drug.

Jim Hill:

Okay. Let's go to the next one.

Holly Wyatt:

All right. This is a good one. If I mess up for a weekend, I mean, and who hasn't messed up for a weekend? And I think what they mean by messed up, meaning I ate off plan, I didn't exercise or whatever. I didn't stay on my plan or even a whole vacation. Is all my progress ruined?

Jim Hill:

Holly, we see this all the time of people that work hard, they achieve success, they have a little setback, and they just give up and say, oh, I went on a binge, I gained four or five pounds, I might as well give the whole thing up. What we've said over and over is this is a long-term process, losing and maintain your weight, and there will be setbacks. If you think there are no setbacks, I'm sorry, it's not true.

Holly Wyatt:

I want to meet you if you've never had a setback.

Jim Hill:

Yeah, exactly. The key, and we preach this over and over, is being able to deal with the setbacks. They will occur. So you've got to be resilient. So you don't let the setback tank all your previous progress.

Holly Wyatt:

And it's recognizing it early. That's, to me, the key. You know, I'm off plan this weekend. Maybe it wasn't planned. Maybe it was planned. If it's planned, then you get right back on. Maybe it was unplanned. All right, I recognize it. And a weekend doesn't become two, three, four months, right? Because sometimes when people get off, they have a hard time getting back on the plan or they don't recognize it right away. And then they feel bad and then it starts to spiral. So to me, being off for a weekend is not the problem. That is not why people stop losing weight or regain weight. It's when they then are off for weeks and months is when you see the regain. And that they need to think of it differently. It's catching yourself. It's always awareness. Knowing how to get back on track. It's one of the things that I practice with my patients and my clients is okay you ate a meal that is not it's an indulgence meal. That's what I call it an indulgence meal. What's your very next meal? What are you going to do? Let's not let that one meal become 10 meals. And then sometimes I even have people who go on vacation and said eat what you want on vacation. But when you come back, Let's get back on. That to me is the key.

Jim Hill:

Again, we always make the distinction between weight loss and weight loss maintenance. With weight loss, you can not put yourself in these situations. You can avoid these things that tempt you. But in weight loss maintenance, you're living your life. This is forever. You can't put all these things aside. So you're going to face these things. You're going to go to parties. You're going to go to buffets. You're going to eat out with friends. And so you have to learn to deal with these things. And the key is, if you do have a setback, get right back on track and move forward.

Holly Wyatt:

Yeah. And it may not be a setback. If you do have an indulgence, right? That's part of life, right? Like you just said, in weight loss maintenance, who wants to live their life and never get to go and have their favorite food at their favorite restaurant? I mean, not me, you know? And who wants to go on a cruise or on a vacation and not get to eat multiple different types of food and really enjoy that experience. Not me.

Jim Hill:

It is.

Holly Wyatt:

Yeah. So the other thing I want to just point out in this, because this is what happens. And I think it's why people throw their hands up. They go on vacation, they eat what they want on vacation and they come back and they've gained eight pounds. And let's say it's been a week or even a 10 day vacation. They gained eight pounds. The majority of that is water, but because they see so much weight gain, it's so discouraging on the scale that they said, oh my gosh, it took me two months to lose the eight pounds and I regained it in one week. And they feel so discouraged by it that they then throw up their hands and stop doing anything. And that's the problem. That eight pounds, the majority of that is water. And if you go right back on, you'll get the water off. And then maybe it's a little bit of fat gain. You can get that off again and go back. But if you allow that number on the scale and you don't understand that it's almost impossible to gain 8 to 10 pounds of fat in a week. You didn't do that. If you don't understand that, it can play havoc with your mind. And then you just throw up your hands and say, well, shoot, two months to get it off, one week to put it back on, not worth it. And that's just not true.

Jim Hill:

All right. Let's do another one. How come my friend eats way more than me, but never gains a pound? It's not fair.

Holly Wyatt:

Yeah.

Jim Hill:

What's going on, Holly?

Holly Wyatt:

This one's perfect for me because this is exactly what I was saying when I was in high school and even in college and even in medical schools. What's the deal? What I can eat and what I look at my friends eating are so different. And how I have to restrict my calories felt like, oh, and then they were eating pizza and cookies and all of this stuff. And I just didn't understand it. And it's really what prompted me to go into this field to try to understand my own metabolism. That's really what it was all about. And it's true. People can eat different amounts. People always say, well, you don't see what I'm doing for activity. Maybe so. There's all different situations. But I think we know now there's different metabolisms. Some people can eat more than others. Some of us have a more thrifty metabolism. I would say if it was a famine, I would survive. I would win in a famine. I would. You could put me out there and I would live. And some of you can probably relate to that. And it's true. It's definitely true. And so some of us have a genetic predisposition. Some people, I say, won the genetic lottery and they can eat more and they don't have to think about it as much, but we know these differences exist. And that's just the facts of it, which I've come to recognize. These are the cards I have. I'm going to deal with those cards. I'm going to play the cards the best I can.

Jim Hill:

So it's sort of a normal curve of metabolism. And there are some people out on the extremes, they probably aren't going to become overweight no matter what. But there aren't many of those, Holly, because 75% of the country is already overweight. So there may be a few people that they're not going to get overweight no matter what. That's a tiny, tiny proportion of the population. On the other hand, are there people that they're going to be overweight in just about any environment? And there are probably a few of those. But again, not many. For most people, you have some ability to modulate your body weight within a range. So think of limits. Genetically, you might have, here's the upper weight you can be, here's the lower weight you can be. Now, where you are in that range is really due to your lifestyle.

Holly Wyatt:

Yeah, I agree with you in theory. I understand what you're saying, Jim. I would say I would put a little bit different spin on it. I do think within that normal range, within that range, not that the far outliers on either side, some people do have to do more, have to work harder, have to push back against their appetite, have to change their environment more to lose weight or to maintain weight. So I think there's variability. It's not just about the environment.

Jim Hill:

No, I agree with that. And genetically, you might have to work harder to maintain a healthy weight than someone else. And those are genetic differences in metabolism. I guess the point I want to make is for most people, you do have the ability to change your weight within a range. You may have to work harder than your neighbor, but you can do it.

Holly Wyatt:

Yes.

Jim Hill:

You're not destined to be overweight. There may be a tiny percent of the population, but for most people, no matter what your genetics, you have the ability to change your weight within your limits.

Holly Wyatt:

Right. Don't just throw up your hands and say, I've got a genetic predisposition. There is nothing I need to do. There's nothing I can do. Don't think that. But I also think it's important to realize, yes, what I'm experiencing that I feel that I have to maybe work a little bit harder is real, and can be explained by your genetics, can also be explained by your environment.

Jim Hill:

Yup.

Holly Wyatt:

But I totally believe that wherever you are in that spectrum, yes, you can make a difference. You can move your body weight.

Jim Hill:

And that's the message we want to get is it might be harder for you due to your genetics, but it's possible to do it. And you and I have studied many, many people who have done it, and they would tell you they have to work hard at it. They also tell you it's worth it. So don't use genetics as the excuse for why you can't maintain a healthy weight.

Holly Wyatt:

Yeah. So I definitely have this bias on this because I bring it to the table. And you know, I get really passionate about this but I do think that the message is, yes, absolutely, you can modify your weight. A hundred percent.

Jim Hill:

All right. Here's a good one. Why does exercise make me hungrier? Should I just eat more or just tough it out?

Holly Wyatt:

Oh, Jim, that's right for you. You love this combination exercise appetite. How is it regulated?

Jim Hill:

So again, exercise can make you hungry. But some really good work from one of the researchers, Holly, you know, that I admire a lot, John Blundell and his group in the UK, they've done lots of studies where they look at exercise and food intake. The bottom line is, yes, if you exercise, you eat a little more. But overall, you don't totally make up for the exercise. So if you're losing weight, you exercise, you're not going to eat the same number of calories you burn. You're still going to have an effect, a good effect. And you know, in weight loss maintenance, this is where it's totally different. Exercise is helpful during weight loss, but it's essential during weight loss maintenance. Because, again, we talked about when you lose weight, your metabolism is going to go down. The way to get it back up is to exercise. So after you've lost weight, you can say, oh, I can try to maintain my weight on 1,500 calories and be sedentary, or I can exercise and maintain my weight on 3,000 calories. So in the short term, yes, exercise might make you hungrier, but in the long term, it actually helps to regulate your appetite, to normalize your appetite so it's matched to your energy expenditure.

Holly Wyatt:

Right. And the data on that's a little mixed, right? You may compensate a little bit, but not totally.

Jim Hill:

Not totally.

Holly Wyatt:

Not totally compensate. And then I'm going to throw in another question for you, Jim, because this is another big, does the intensity of the exercise matter? I know some people say when I exercise really intensely or do a HIIT type, high intensity type exercise, it tends to cut my appetite. But if I do an endurance or slow walk, I tend to stimulate my appetite. Any thoughts on that?

Jim Hill:

Yeah, that's actually where we need some more research because there is some intriguing data that intensity might matter. You know, you and I years ago worked with the National Weight Control Registry found that not only do people exercise a lot, they actually do more high-intensity exercise and more weightlifting. So this is where I think we need more research. But at the end of the day, the amount of exercise is critical. You don't need to exercise to lose weight. We rarely see anyone who can keep weight off without a lot of exercise.

Holly Wyatt:

Yeah. What I tell people is to go out and try it. Definitely you need the exercise for the reasons you talked about. But go out and see. If you walk and you think it's increasing your appetite, try to do maybe a little bit more higher intensity or vice versa. You can kind of get to know your body. We may not have the data yet with the research to for sure say this is what's going on. But that doesn't mean you can't go out and try and see what's working for you.

Jim Hill:

Absolutely. I recommend some high intensity, some weightlifting. We don't have all the data, but I guarantee you there's no downside.

Holly Wyatt:

Yeah. All right. I'm going to ask you the next question. I've saved this one for you because I want your answer on it. Does sex count as exercise? Because honestly, I'd rather do that than go to the gym.

Jim Hill:

So I've been studying up on this question And I hope my wife is listening because I've told her all along I had a lot of expertise in this area.

Holly Wyatt:

Oh, my gosh.

Jim Hill:

I think you're going to get me in trouble on this one but, yes. So does sex burn calories? Yes. And I actually looked it up. You know how many calories you burn in sex? On average, you burn about three to four calories per minute. Right. Now, it varies with intensity. You can increase it.

Holly Wyatt:

Oh, Jim, it varies. Doesn't it?

Jim Hill:

It varies.

Holly Wyatt:

Okay.

Jim Hill:

You need to four calories per minute. So, you know, I'm not going to get into how long sex lasts, but you can see that overall, the point is it's fairly minimal. If you're walking, Holly, at a brisk pace, you burn five to six calories per minute. Yes, it would be lovely if we could say that sex is a wonderful way to increase your energy expenditure and your physical activity, but it really doesn't work out to be that much. And I'm not discouraging it, so don't get me wrong. There are other reasons other than burning calories, but it is not a panacea. If you want to just increase your energy expenditure, you're better to go for a walk.

Holly Wyatt:

Yeah, so I mean, it's all about intensity. I looked it up too. I was like, this was, I had to do a little research myself.

Jim Hill:

Wouldn't it be nice if it were the magic way to increase your activity?

Holly Wyatt:

Yeah. I also got 3-4 calories per minute versus running is around 8-10 calories per minute. And so it is intensity. So I guess, Jim, if you were really intense in the bedroom or wherever.

Jim Hill:

Yeah. But the problem though is the duration, Holly. You're not doing this for one to two hours.

Holly Wyatt:

Maybe that's your problem, but maybe not everybody's problem.

Jim Hill:

All right. You're getting me into trouble.

Holly Wyatt:

I get it. I don't think it can replace your workout, but it's movement. It counts.

Jim Hill:

We're not against it.

Holly Wyatt:

We're not against it. There we go. All right. Do you want to ask me the next one?

Jim Hill:

Yeah. Why do I poop less when I diet? Am I broken?

Holly Wyatt:

Get this question all the time. Constipation, change in bowel habits. They know I'm a doctor, so people will ask me this all the time. And so when you change what you're eating and you're changing the amount of food or the type of food coming in, yes, it changes, What's coming out? That's how I think about it. Yes. So decrease in carbs, decrease in fiber, just the decrease in the volume or the amount of food you're eating can cause you to, you know, poop less or even become constipated. There's less waste. And so this is really what happens. Your gut microbiome can change. Your gut health can change. Lots of things are changing. So it makes sense that your bowel habits would change, I guess is what I'm saying. And it makes sense that it might be a little bit less than you were before. I always say, if you're noticing this and it's causing a problem for you, if it's just less, then that's not necessarily a problem. But if it's causing a problem for you, if you're constipated, et cetera, more water, more fiber, more movement. Those are the three things I prescribe first. Get out there, do a brisk squat. Gravity is your friend. More fiber, more water. That can kind of increase this. But a lot of times I say this is normal, Unless there's some negative things, pain or anything like that going on, then that's abnormal. But this is normal. You change what you're eating, you change what you poop. What comes in changes, what goes out changes.

Jim Hill:

Makes sense. So don't worry.

Holly Wyatt:

Yeah.

Jim Hill:

All right. You're on a roll. Take the next one too. Why do I crave junk food when I'm stressed? Is my body trying to sabotage me?

Holly Wyatt:

Yeah. So I don't think it's trying to sabotage you, But I do think there is a relation in some people between craving food, especially craving carbohydrates, and stress. I mean, there's cortisol. When you're stressed, cortisol is a hormone that's released. And for some people, that can stimulate them to want to eat, especially carbohydrates. Some people, when they feel stressed, they've learned to try to numb or change that feeling with food. So it can also be that route. So I do think there's this relationship that some people feel the urge to eat certain food when they're stressed. I don't think it's the body trying to sabotage them, though. I think it's more that this actually could have been a mechanism a long time ago that was advantageous, right? You're stressed. You're going to need energy because a lot of times the stressors back many, many years ago was you're being chased or you need to do something with, expend a lot of energy. And so it would make sense to eat. But nowadays, we don't need that, right? We have stress for reasons that don't increase energy expenditure, and we have food that's easily available, and so it leads to weight gain. So it's kind of backfired on us. So I think it's true. If you recognize it, there's things you can do to help. Not everybody has it, but I do think some people associate or have that stress and craving junk food.

Jim Hill:

Great. Okay. Got to manage that stress.

Holly Wyatt:

Yeah.

Jim Hill:

All right. Late night eating. Is it bad? If I stay within my calories, does it matter? So this is the whole issue of timing of eating, Holly. And again, there was a lot of research a few years ago about how late night eating was really, really bad. And I think for some people, the problem is they would eat late at night and they would really binge and eat a lot of calories. So at the end of the day, it's all about calories. And for some people, eating late at night causes them to eat a lot. And then you go to sleep where your metabolism at its lowest point during the day. That could be bad. But I don't think it's something that's necessarily a problem for everybody. And this is why we're learning about individual differences in meal timing. Why you and I used to say breakfast is critical. Now we've modulated a little bit. It may be critical for some people, not others. If you're eating late at night and you feel like you sort of binge out and eat a lot of calories, that's one thing that you should think about changing.

Holly Wyatt:

Yeah, I think a lot of people tend to eat more at night for lots of reasons. They'll be mindlessly eating around with the TV on.

Jim Hill:

You're watching TV and you're not paying attention. You're just eating those cookies.

Holly Wyatt:

Right. Stress is high. So, yeah, eat more to kind of like we just talked about to combat the stress. So, I think there's lots of reasons why nighttime tends to be a time of day when people, on average, tend to eat more calories. So, if that is true for you and you're going to eat more calories, then it's going to matter. But I do think that if you stay within your calorie limit, I don't think the timing of day matters as much as some people think.

Jim Hill:

Exactly. But if you are someone that eat late at night and you sort of mindless eating or you eat too much, that's one thing to start changing. Stop eating a little bit earlier in the evening.

Holly Wyatt:

Although I will say, and this is where I think we have to keep an open mind, we still don't understand that timed eating versus fasting and having a period where you consume no calories, and should that be at night or does that, I still think we're learning about the idea of having a period where you don't consume calories and how that might impact you.

Jim Hill:

Right. We've talked about that before. A period of not eating allows your metabolism to burn fat, which is what you want it to do. And we've talked about that in other episodes. But this is where the research is really moving forward in this area. And ultimately, I think different people are going to benefit differently from difference in timing of eating. And so stay tuned. There will be more data coming out on this soon.

Holly Wyatt:

Yeah, I agree. I agree. All right. Do you want me to do the next one?

Jim Hill:

You do the next one.

Holly Wyatt:

I had to look this up. I had to look part of this up.

Jim Hill:

I don't have an answer.

Holly Wyatt:

I have an answer, but...

Jim Hill:

All right, Holly, why do I get bad breath when I diet? And why is my sweat smellier?

Holly Wyatt:

All right. So I got the breath. I understand the breath. A lot of times when you restrict your calories, especially if you restrict your carbohydrates, you go into something called ketosis and that can produce, one of the ketones that's produced is acetone. It's very volatile and it can come out in your breath and you can smell it. Some people say it smells kind of sweet or fruity or some people say it smells like a nail polish remover, but it does change your breath. And there's been a lot of kind of people talk about that. There's been some research on that. So that's what's happening with that. But then I was like, I did not know that your sweat was smellier. So I had to look this up. And there is no real research on this. A lot of anecdotal people saying, I feel like my sweat has changed and I'm smellier, et cetera. But no real research to support this. It would be along the same lines of the ketosis is changing your sweat. But I think you also have to realize changes in your diet, changes in hygiene. So you've suddenly started to maybe work out more and you're sweating more, you know. Just individual body chemistry can also change this. So I don't know for sure how. I think some people are saying yes and some people are saying no. We don't have great research on this. But I do think that the breath is due to the ketosis and maybe, maybe the sweat.

Jim Hill:

Okay, good answer.

Holly Wyatt:

You don't have anything to add on that, Jim? Come on.

Jim Hill:

I have nothing to add on that one.

Holly Wyatt:

Nothing to add on that one. Okay, all right.

Jim Hill:

I can add on the next one, though.

Holly Wyatt:

All right, let me ask you the next one. Can I really drink alcohol and still lose weight? Be honest.

Jim Hill:

So alcohol, I will have to say, is a real problem for a lot of people. Now, let's look at calories. Calories per gram. Carbohydrate and protein are about four calories per gram. Fat is nine calories per gram. So that's why fat is particularly important. You know where alcohol comes out, Holly?

Holly Wyatt:

I do.

Jim Hill:

Comes out at seven calories per gram. So you get more calories per unit of intake than carb or protein, less than fat. But here's the other thing that alcohol does. Your body can't really store alcohol. So when you drink alcohol, you have to burn it. You have to use it as fuel, okay? What that does is to spare other sources of fuel. So if you're burning alcohol, it means you're not burning something else. And that something else is fat. So you're burning alcohol, but you're not burning fat. And so people who can manage their food intake really well sometimes really get hurt by alcohol consumption. Now, we're not saying never drink alcohol, but if you want to manage your weight, you have to recognize that you can get a lot of calories in with alcohol. So you have to figure out how to work a reasonable amount of alcohol into your lifestyle.

Holly Wyatt:

Yeah, I tell my clients and patients that when you drink that glass of wine every night, it's turning off your fat burners for some period of time. Now, they're going to turn back on and total calories is going to be the big driver. But it is turning off fat burning because it has to. It has to burn, like you just said, has to burn those alcohol calories first. It's going to prioritize them. And then the other big thing is when you drink the glass of wine, or let's be honest, two glasses of wine or whatever, then you maybe eat a little bit more. It kind of goes hand in hand. And so then you consume more calories, which then we understand how that could impact your weight.

Jim Hill:

So I think, Holly, during weight loss, we always say it's a good idea to really limit alcohol intake. During weight loss maintenance, now again, it's about finding a lifestyle and a diet that can be forever. And so we're not saying never drink alcohol, but we're saying you have to figure out a way to work it in, recognizing that it's going to shut off your fat burners. It's a higher calorie intake than you get with protein or carbs.

Holly Wyatt:

Yeah. I think we need to do a whole episode on alcohol because some of the, when I was looking up, doing a little bit of research for this podcast, what's really hot right now is this idea, is alcohol a carcinogen? I think the World Health Organization has come out and they want to put like a cigarette type warning on all alcohol. And that's more about it's cancer. Does it cause cancer? So let's do a whole episode on alcohol because all the different things, metabolism, cancer, all that. I think that's a really hot area right now.

Jim Hill:

Okay, Holly, let's do the last one. I've lost weight before, but I always gain it back. Am I just doomed to failure?

Holly Wyatt:

Absolutely not. This is what I feel really strongly about. And, you know, this has been my whole career and a big part of your career too, Jim, is I do believe and I think there is good data that you can keep weight off. I'm not saying, you know, it's for everybody, but I do think if you want to keep the weight off, there are things you can do that will help you in that process.

Jim Hill:

From the National Weight Control Registry, the database we follow the people that are successful long-term, almost all of them have failed many times before. It's not that, boy, these are people that just try weight loss first time it works. They have failed on every fad diet out there, but they finally figured out what works for them and they're successful. This is a big one. You are not doomed. I don't care if you failed 50 times to lose weight. Do not give up. You're not doomed. You can do it.

Holly Wyatt:

And I would even say all those failures really aren't failures. They're even helping you. You're learning. And we, once again, we've done a whole show on this. What is success? And not being so hard on yourself. You failed 15 times. Now you've learned a lot. You've lost weight. You may have maintained it for a short period of time and then regained it, that's success. You go back to weight loss. I think we need to reframe it too.

Jim Hill:

All right, Holly, some good things we've covered today. Let me sort of summarize. Your body isn't broken. It's just a little quirky. Sometimes it stalls. Sometimes it craves weird things. And yes, sometimes it makes you smell funky. Welcome to the club. Metabolism isn't fair, but whining about it won't burn calories. Some people can eat whatever they want. you probably aren't one of them. Move on.

Holly Wyatt:

Yeah, if you're on this podcast, you're probably not one of those people. And I love it. Move on. Let's stop whining about it. It just is. Yes.

Jim Hill:

All right. Exercise is great, but unfortunately, sex isn't going to replace your workout. Sorry, but unless you're going all out for several hours, the treadmill will work better.

Holly Wyatt:

Or maybe just even an hour, Jim, but I think that would be hard.

Jim Hill:

Let's move on here. I might get in trouble. Skipping late night snacks won't change your life. It's what you eat all day that counts. It's not just what happens after dark. And finally, messed up over the weekend? Cool. So did everybody else. One bad meal won't ruin your progress. Just don't make it a bad week or month.

Holly Wyatt:

Yes. Love it.

Jim Hill:

All right. These are good. And for our listeners, if you've got questions for our unfiltered episode, no matter how bizarre, send them in and we will address them.

Holly Wyatt:

I'll even say the more bizarre, the better. I kind of like them. Give us the bizarre ones. Yeah. The ones we haven't heard before. I love those.

Jim Hill:

All right. Well, thanks everybody. And we'll talk to you next time on Weight Loss And.

Holly Wyatt:

Bye-bye.

Jim Hill:

And that's a wrap for today's episode of Weight Loss And. We hope you enjoy diving into the world of weight loss with us.

Holly Wyatt:

If you want to stay connected and continue exploring the “Ands” of weight loss, be sure to follow our podcast on your favorite platform.

Jim Hill:

We'd also love to hear from you. Share your thoughts, questions, or topic suggestions by reaching out at [weightlossand.com](http://weightlossand.com/). Your feedback helps us tailor future episodes to your needs.

Holly Wyatt:

And remember, the journey doesn't end here. Keep applying the knowledge and strategies you've learned and embrace the power of the “And” in your own weight loss journey.