Episode #148: Is Exercise Helping or Hurting Your Weight Loss Goals?

In this week’s episode of Conquer Your Weight, Dr. Sarah Stombaugh dives into one of the most common questions she hears from patients: Can exercise actually hurt your weight loss goals?

While movement is essential for health, the type, amount, and fueling of your exercise can make all the difference. In this episode, Dr. Stombaugh breaks down the science behind how different kinds of exercise affect your metabolism, your hunger, and your long-term results.

What you’ll learn:

• Cardio vs. resistance training: How these two forms of exercise affect your body differently—and why strength training is key to preserving muscle and metabolism.
• When cardio backfires: How long or intense cardio sessions can trigger hunger hormones and make it harder to stay in control of your appetite.
• Fueling your body: Why under-eating (especially on GLP-1 medications) can sabotage your performance, recovery, and weight loss progress.
• Medication awareness: How to know if your GLP-1 or other appetite-suppressing medication dose is too high to support healthy exercise and nutrition.
• Finding your sweet spot: How to choose movement that feels good physically and mentally—so you can stay consistent for the long haul.

Exercise should support your weight loss—not fight against it. The best routine is one that helps you build strength, manage hunger, and feel good in your body, both inside and out.

Ready to get started on your weight loss journey? We'd love to support you! We're now enrolling patients for in-person visits at our Charlottesville, Virginia office and for telemedicine visits throughout the states of Illinois, Tennessee, and Virginia. Visit www.sarahstombaughmd.com to learn more and get started today!

Transcript

Dr. Sarah Stombaugh:

This is Dr. Sarah Stombaugh, and you are listening to the Conquer Your Weight Podcast.

Announcer:

Welcome to the Conquer Your Weight Podcast, where you will learn to understand your mind and body so you can achieve long-term weight loss. Here's your host, obesity medicine physician and life coach, Dr. Sarah Stombaugh.

Dr. Sarah Stombaugh:

Hello everyone, and welcome to this week's episode of the Conquer Your Weight Podcast. We are talking about exercise and is your exercise hurting or helping in your weight loss journey? Now, before you roll your eyes and turn off this episode, like of course, exercise is a good thing. Hear me out because exercise, of course, is a good thing, and it needs to be done properly in a way to really support our bodies both now as well as in the long term. I found that this can be one of those things that even when really well-intentioned of like, hey, I'm gonna hit it hard over the next month, or you know, I'm really going to like get back on the horse or whatever, this is one of those things that even if it's well-intentioned, can really backfire in a pretty significant way. So let's dive into why that is the case. 

For one, let's talk about what is the role of exercise. When we think about it, exercise is hugely important. If I could think about really just about any intervention and put it into a pill and then tell everybody in the world to take it, I don't know if exercise or sleep would be the top intervention, but for sure it would be in the top two to consider exercise. If I could just put that in a pill, give it to everybody. Exercise plays such an important role in our health. And exercise is supposed to be fun. You know, we, if you think about being a child and running and jumping and playing and laughing and skipping, exercise can and should be really fun. It should not be punishing your body, like beating yourself up, making yourself stay longer, putting yourself to the point where you are getting injured or feeling really overly sore the next day. Honestly, it's not the greatest way in the world to burn calories. I think that's probably a pretty controversial opinion. But when we think about calories in versus calories out, we know that exercise, when we're really active, our body will usually respond by increasing hunger signals. And we typically, you know, even let's say we burn 200 calories on the treadmill, our body will later be 200 calories hungrier. And so we typically will match those in and out needs. And so it's not honestly the best way to just simply burn calories. The real role of exercise is that it's supporting our health, our longevity, supporting our muscle mass, which can help us be strong, can help us get up if we've fallen or get up from a chair or get up from bed, can help us to be strong if we've had a significant injury or an illness from which we need to recover. And certainly exercise can play a really important role in our weight management, both in active weight loss, but there's actually really good data specifically on exercise in weight maintenance. Whether you're talking about maintaining a weight that you've been at for a while or if you've lost weight and now you're working to maintain that weight, exercise can absolutely play a really significant role in weight maintenance. Now, when we think about the different types of exercise, certainly there's many, but broadly we can break it into two different categories, thinking about cardio as well as resistance training. 

Now, cardio is called cardio for a reason because it's really good for our heart. When we do cardiovascular type fitness, where we are getting our heart rate up, we might be huffing and puffing. This can be things like walking, jogging, running. It can be biking or rowing or swimming or dancing, lots of different things that get us up, gets our heart pumping, gets our lungs breathing hard. And this is really good for increasing our endurance, really good for our, you know, heart health and our lung health, and really can help us feel uh really great and sort of energized while you're doing it as well. And there's some downsides to it too, though. You know, we know that cardio training in particular can really increase hunger afterwards, and we'll talk about that in a little bit. Um, but even can potentially cause muscle loss if you were exclusively focused on doing cardiovascular training and you are not adequately fueling your body. So especially not getting enough protein, but also carbohydrates after exercising, this can create muscle loss. So, particularly if you're not doing muscle building type exercises, cardio is meant to be balanced with resistance training. Now, I think there's been a lot of conversation about resistance training over the last few years, and I think that's really awesome. 

But resistance training can look like a lot of different things. It can be really traditional, you know, going to the gym and lifting weights, whether that's dumbbells, whether that's barbells, whether that's some of the corded, um, corded isn't the right word, but some of the uh machines, you know, that it's on the, I'm sorry, I can't think of the word, but it's on the, you know, chain, um, you know, and it has attraction and you're able to lift those weights. So it can look like a lot of very traditional going to a gym, working with a personal trainer, maybe you're doing a training program, but it can also be things that you're doing on your own. It can also be body weight resistance, it can be, you know, doing squats, doing lunges, doing push-ups, doing wall sits, doing things like that. It can be bands at home. So it can be things like resistance, well, at home or in the gym, I guess, but it can be resistance bands that can create training. There's a lot of different ways by which you can strengthen the muscles. It can also be things like yoga or Pilates. I think Pilates is maybe one of the best resistance trainings that's whole body. There's a lot of core focus, could be a really gentle movement, but does still really support you from a resistance training standpoint. But it can honestly look like a lot of different things. And when we think about resistance training, we want to make sure that we're working different parts of our body. So working our upper body like our arms, working our lower body, our legs, working our core, including the front of the core, like our abdominal muscles, working the back of the core, all of our back muscles. And working each of those parts will be really important for supporting our overall health. 

Now, with that popularity, I think has become really a lot of conversations about ways that you can do this and a lot of conversations about using resistance training, especially in the weight loss journey. Now, one of the things that can be challenging, you know, we talk about weight loss, but the reality is you don't care about weight loss. You actually want fat mass loss. You want to be able to support, maybe even grow your muscle mass during a weight loss journey. And so when we are doing resistance training, the goal of this is that we are increasing the lean muscle in our body. And so we don't always see the same shifts on the scale and see that downward movement. But what we do start to see then is this proportion where our muscle mass is increasing, our fat mass is decreasing, and we have this better body composition, which can really drive improvement in terms of metabolic disease. Certainly, too, resistance training in the long term. You know, we think about both cardio and resistance. This can be really important for longevity, supporting us in different ways to help keep us living longer and stronger. Resistance training can also, as I'm thinking kind of the like the little old lady, for example, it like doesn't have to be these crazy intense things. It can also be stuff like gardening, for example, where you're squatting down and standing up, where you're carrying a bag of potting soil. It doesn't even have to look like traditional gym exercise. It can look like a lot of other things as well. And that can really contribute to some of that longevity. So we think about both of these types of exercise, and honestly, they're both important. If you look at what are the general recommendations for exercise, you will see a lot of different things out there, like 150 minutes a week of moderate intensity exercise and two days per week of resistance training. That's a pretty standard exercise recommendation. You may have been told something different based on your own health conditions, but that's probably the most general one out there. 150 minutes a week of cardiovascular with two days of resistance training is a really good place for most people to start. 

But when we think about what are the downsides to exercise, one of the things I mentioned with cardio is that exercising can actually really drive hunger. And I think that this is one of those things that you really want to pay attention to. A lot of times at the very beginning of someone's weight loss journey, I actually do not have them layer in exercise unless it's something that they're already in a really good routine of doing. We do know that particularly cardiovascular training can really increase hunger. And this is that why I said, you know, you might see you've burned 200 calories on the treadmill, but your body will actually increase appetite in order to make up for that caloric loss. So as our body senses this energy expenditure, it will respond by increasing the hormone ghrelin, which tells your body, hey, you should be eating right now. You should increase your appetite. And you may finish a run or a bike ride, and it's like, oh my gosh, I am ravenously hungry. I could eat just about anything in sight. There may also be some justification coming up of like, okay, I worked out today, I saw that I burned this amount of calories. And so, like, I can absolutely have that dessert because I earned it. And so this like I deserve mentality comes up. 

And I think when your mind starts thinking, like, oh, I deserve that, like I deserve to treat myself, I think it's a really powerful thing to stop and see and to recognize because, like, of course you do. You deserve like all the most wonderful things in the entire world. You deserve to be loved, you deserve to be taken care of, your body deserves to be nourished. And that deservedness can actually start to slip over into entitlement territory. And so sometimes we start playing these games of like calories in versus calories out because we've been told that, right? We've been told if you just eat more or eat less and you move more, okay. If you burn this number of calories on the treadmill, then you can go eat that number of calories or even eat less than that number of calories and still be in a caloric deficit and therefore you'll lose weight. So we play these mental games, but then we also play this like, well, I was really good today. I did the things, like I burnt all these calories, like I deserve to have a dessert. And it can be a really good place to check yourself because sometimes that can be where we start really struggling with like what is our relationship with food and why are we making the different choices that we are? And I believe very strongly that all foods can fit in your diet. And we want to be really intentionally about intentional about how we're choosing and fitting those in and feeling like we're really fueling our body. 

So, this is one of the big things that comes up because if you finish a long run or a bike ride and you are like ravenous afterwards, it can be so, so hard because if you haven't been working on some of those tools for how to deal with it, you can be fighting this really significant hunger that like, and I use the word fighting intentionally, of like you feel like you're fighting with your body because you're trying to stick to some healthy eating goals and yet you're just ravenously hungry and just about everything in sight looks good. So managing this overhunger that can come, particularly from intense cardio training epis or events, may look like a lot of different things. For one, hydration, hydration, hydration, hydration. Um, when I say this, certainly I mean water, but I may also mean electrolytes, especially if you're sweating, you want to make sure you're replacing particularly your sodium, but maybe potassium and magnesium as well. I will sometimes, and this is gonna sound totally crazy, so hear me out. I will sometimes even have patients have a regular sugar Gatorade, for example. If let's say it's the middle of summer, they're horseback riding, they're running, they're biking. You know, I'm based in Virginia. It gets really hot and humid here in the summers. And so I have patients for whom they are outdoors doing an activity for an hour. They get incredibly sweaty. And actually having something like Gatorade, that's what it was designed for. You know, Gatorade was designed at the University of Florida for the football team, for those football players who were sweating it out in the Florida summers, and this was designed to be a beverage that helped to replenish those losses. And very commonly we do not actually need that amount of sugar. 

However, if you are someone who is doing any sort of significant endurance athleticism, and particularly that you're finding you're getting overly hungry afterwards, and especially if you're finding that during the exercise, you're getting really weak and feel like you're not adequately fueled. Sometimes having sugar, and I say this meaning Gatorade, you know, you see marathon runners, for example, eating those like jelly sugar packets. There are, it's important to get that sugar active into your bloodstream, and your body is honestly going to burn it instead of burning, you know, like it's gonna burn it actively rather than taking that and storing it away as energy for later. Now, I'm speaking really to a very specific person here who is doing that really intense exercise and particularly notices that they're feeling really petered out and really fatigued by the end of that training session, it may make sense to add in sugar there. Like I said, it sounds totally crazy, but talk with your physician, talk with your nutritionist, with a trainer, someone who sees the type of movement that you're doing and can help give you advice on how to appropriately fuel your body during that. And so hydrating, whether it's water, water plus electrolytes, water plus electrolytes plus sugar, those may all make sense depending on your situation. 

You also want to be thinking about foods like protein, foods like fiber, things that create satiety or fullness and help you to feel full for a while afterwards. So a lot of times we may be craving that sugar in the form of a carbohydrate. You finish that intense cardiovascular training exercise, you're feeling ravenously hungry. A lot of times the things that feel or sound really good right then are going to be those things that are really quick hit of energy, aka sugar. And so it would be okay to have that, but give yourself to the well-bounded, well rounded meal of protein and fiber, such that you may feel and get that energy boost quickly, but it's also going to stick with you for hours later rather than feeling like it's wearing off. And so this is where it comes to the fueling your body part as well. Whether you are taking a medication, like one of the GLPs, for example, and having appetite suppression from that, or whether you're just doing a really intense exercise session where you're needing fuel during it. I really love to think, honestly, just in general, about fueling our body. I think this can be a really powerful verb to think about what is the fuel that we're putting into our body. I guess that's a noun, but fueling in terms of, you know, what are the foods that we're eating? How are we fueling our body? And to think about what are the foods that we are feeding our body in order to help it be energized. 

And so this may be the foods that we're eating before a workout, maybe perhaps during a workout or immediately afterwards in order to help our body feel strong, to help our body recover. We think about building muscle, and there's all this conversation of like protein, protein, protein. And that is absolutely true. And carbohydrates play a really important role in building muscle as well. So proteins and carbohydrates consumed together can be really important. I will often talk to my patients about when they're wanting to build more carbohydrates into their diet, that immediately after an exercise session can be a really appropriate time to do that because it's a time where their body needs that type of fuel. And of course, as I was saying before, with the protein, with the fiber, making that you are making a situation where you're creating that more well-balanced energy response and giving yourself not just that immediate hit of energy, but also that fuel that's going to sustain you for hours later. And so, especially if you're on like a GLP medication, if your appetite is overly suppressed and you're having trouble exercising, certainly if I'm your physician, reach out. If you are not my patient though, reach out to your physician and ask them about this. Because if you are feeling weak, if you are feeling underpowered during your workout, that may be a sign that you're on too high of a dose of medication and you may need to actually bring that dose down or think about other ways that you can help support in fueling your body. I think one of the biggest ways that exercise can be a challenge is we don't always choose exercises that maybe we even enjoy or that feel good in your body. And I feel very strongly that when we are creating a weight loss plan for ourselves, we need to create things that feel very sustainable. 

So if you imagine five years from now, 10 years from now, does this feel like a sustainable thing for you? If the answer to that question is no, I will question if it's the best intervention for you in the short term as well. So we want our bodies to feel physically good. We also want it to be mentally enjoyable. So physically, if you are having significant pain during your workout, that is a sign that that is not the best thing for you. You need to make sure that that pain is evaluated, that you have a plan for how you're going to treat that, and make sure that you're not doing anything to actually worsen or hurt yourself due to the type of exercise you're doing. You also want to pay attention to the way you're feeling after your workout, both in the immediate hours as well as the days afterwards. If you are feeling so sore that you cannot walk and you cannot move your body, you have simply overdone it. You know, a lot of times we may be excited, we may be ready to just like get back in the game and do all of the things. But if you are finding that you are overdoing it to the place where you get set back for days and you just can't even like walk or do the things you know you need to do, that is the sign that you are overdoing it. And so I recommend to scale back the time, the intensity, maybe both of those two things so that physically your body is feeling good during as well as after. And mentally, I want you to choose things that you enjoy. I want you to think about the activities that afterwards you just feel maybe a sense of calmness, maybe you feel kind of geared up and excited, maybe it feels super fun to move your body in that way or participate in a class with other people that you really enjoy. It doesn't have to be the exact same exercise for the next many decades. It can be, but are you choosing the type of exercises that feel both physically good and mentally good? You're enjoying it, you're motivated to get out of bed, you're motivated to put down your work, you're motivated to go there because it's fun and enjoyable rather than just like this, oh, I have to go to the gym right now type of thing. And so choosing those type of movements, and it can look like a lot of different things, whether you like walking, running, swimming, dancing, yoga, pilates, rowing, golfing, you know, I could think of a many million different activities, and there are so many more beyond what I would even, you know, list here. And so think about the things you've enjoyed now, the things you've enjoyed in the past, and how can you do that in a way that feels really good for your body? So exercise, super important, and I want to make sure that as you're doing it, you're doing it right, choosing exercise that you enjoy, that feels really good, that you're fueling your body before, during, and afterwards, that you feel like you can make the choices that will help you to be in line with your goals. And if you're feeling frustrated, feeling stuck, and you just don't know what is the next step, I would love to support you in your journey. I see patients in person in Charlottesville, Virginia, and by telemedicine throughout the states of Illinois, Tennessee, and Virginia. To learn more, you can visit www.sarastamba md.com. Thanks for joining me today. See you all next week. Bye bye.