Conferences are a hotbed of divergent opinions on the same issue, which is one of the things that make them so exciting.
Today, there was a press conference (which I skipped to attend the session I just blogged about) about how 3 months of aerobic exercise decreased body fat and caloric intake in overweight and obese folks. Researchers think that changes to a CNS factor are the reason; they spotted increased levels of a protein that they think suppresses appetite.
A reasonable hypothesis might be that exercise inhibits appetite, which helps people eat less, and thus diet plus exercise work in tandem to help people lose weight.
Yet just yesterday, Daniel Bessesen, MD, of the Univ of Colorado in Aurora told an audience that if their patients really want to lose weight, the key is diet, not exercise. He said that, to lose weight, a person needs about a 500 kilocalorie deficit each day compared to her current diet, and that's really difficult to achieve through exercise. Exercise, he noted, has great health benefits and is helpful for maintaining weight...but it's not going to get those initial pounds off unless the person also diets.
Further, he said, past research has shown that the amount of weight a person loses from dieting, compared to dieting plus exercise, is pretty much the same. Exercise has the advantage of preserving lean body mass-- which may or may not be important to patients.
What do you think? Any internists out there want to share the weight-loss strategies that worked (or didn't) for their patients?