The Secret Science & Practice of Weight-Loss Maintenance with Dr. James Hill

Dan is joined by Dr. James Hill, co-founder of the National Weight Control Registry.

In part 2 with Dr. Hill, they discuss the intricacies of weight loss maintenance, emphasizing the importance of physical activity, dietary awareness, and the psychological aspects of maintaining weight loss. Dan and Dr. Hill then discuss the significance of a consistent routine, identifying personal challenges related to weight gain and how to address those challenges effectively.

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Special Guest: Dr. James Hill

Check out Dr. Hill's Podcast: Weight Loss And ...

Podcast episode: Talking with your doctor about GLP1s

Pre-Order his upcoming book:
LOSING THE WEIGHT LOSS MEDS
In the U.S.
In Canada

Or his previous book:
THE STATE OF SLIM
In the U.S.
In Canada

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Chapters

• 0:00 Introduction
• 2:00 Core Habits of Successful Weight Loss Maintainers
• 6:00 Routines, Environment, and Behavioral Strategies
• 8:30 Physical Activity: Planned, Lifestyle, and Reducing Sedentary Time
• 12:00 Monitoring Tools: Diet Records, Weigh-Ins, and Feedback
• 15:00 From Dieting to Maintenance: Mindset and Motivation
• 17:00 Three Common Weight Gain Profiles
• 22:00 Victim, Victor, and Voyager: Shaping a Sustainable Mindset
• 29:00 Practical Tools, Community Support, and Final Takeaways

Transcript

0:00

[Music] I can't tell you how excited I was to talk with one of the world's authorities on weight loss maintenance. Therapists are regularly working with patients who are struggling with weight-related concerns, and this is one of the rare opportunities to understand the science. Also, based on some listener feedback from the last episode, I want to make clear that my guest doesn't have any financial investment or incentive in terms of GLP1 medications. And on that note, I do want to plug my guest's upcoming book,"Losing the Weight Loss Meds" a 10-week playbook for stopping GLP1 medications without regaining the weight. I was fortunate to get a pre-published PDF of the book so that I could prepare for our conversation, but I've already gone online prior to copy, because I found the practical advice about weight loss maintenance so helpful that I wanted to be able to grab it off of my shelf. There are links in the show notes if you want to pre-order a copy. I'm your host, Dr. Dan Cox, professor of counseling psychology at the University of British Columbia. Welcome to psychotherapy and applied psychology. Rye Dye, Deep, with leading researchers to uncover practical insights, pull back the curtain, and hopefully have a little bit of fun along the way. If you find the show valuable, subscribe on your podcast player, or you're watching on YouTube, hit the like button, and subscribe to the channel. It's one of the best ways to help us keep these conversations going. So without further ado, it is my absolute pleasure to welcome my very special guest, Dr. James Hill.[MUSIC] We've studied this for 30 years or longer, and there are some commonalities. There are always exceptions. It starts with fiscal activity. We, of the 10,000 people that we've started in the National Weight Control Registry, 9% are maintaining their weight loss without fiscal activity. 9%, 91 are not. And all our research suggests that if you want to maintain your weight and you're not willing to crease your fiscal activity, your chances to success are very low. In the National Weight Control Registry, they do regular fiscal activity, and they do a fair amount of fiscal activity. The average is about an hour a day. Our day is at a lot of, is at a little one hour out of 24. It's a lot compared to what most people do. These people are keeping off an average of 70 pounds. You give me an hour a day, doesn't have to be altogether to help keep off 70 pounds. This is where my state comes in. Are you seeing that as, oh my God, I have to do an hour a day. I can't do that. Are you saying, oh, with only an hour a day, I can increase my chances of keeping off my weight. This is where the brain comes into it, how you approach it. So they do a lot of fiscal activity. They pay attention to what they eat. In the National Weight Control Registry, they keep diet records occasionally. And we encourage people to keep diet records, not because they're accurate, but because it forces you to pay attention to what you're eating. I mean, we've had people with the diet records say, oh my God, I wrote it down. I had no idea I was drinking five sodas a day. Well, eating is such automatic that it helps to do that. So they occasionally do that. And we encourage people not to do it all the time, but every now and then, write down what you're eating. They weigh themselves. And this is one where we talk a lot about that in the book. There's a lot of feeling both ways on weighing yourself. And what we recommend people weigh themselves every day. And when I ask people in the National Weight Control Registry, why do you weigh yourself regularly? The answer is, well, how am I going to know if I'm gaining weight if I don't weigh myself? But at the same time, we talk about don't give the scale power. It's not an emotional evaluation of you. It's simply a tool. And the other thing about weighing yourself, your weight, I don't know about your weight, my weight can bounce up and down three, four pounds from day to day. And that's not fat. That's water. So we're big on keep track, but look at trends over time. Average a week's weight rather than look at day to day. So physical activity, watching what they eat, they watch portion size, they look at energy density. One of the things that was obvious is they rarely consume any beverage with calories. And again, I remember talking to one saying, you know, why do you do that? It's like, oh my god, I want to get food. I love food. I don't want to waste calories in a beverage. So they drink a lot of water. They also use non-colorically sweetened beverages. And again, out in the media, that's a big deal. Artificial sweetener is out. I will tell you, I think on the list of things to worry about, that's not even the top 100. We find people with negative consequences. A negative consequences of artificial sweetener. You would have to consume so much of these to have a negative effect. People use them as tools and they don't overdo it. So they're not drinking tin diet, so does a day. But what they tell us is every now and then, I want something that's a little sweet, but I don't want calories. Well, guess what? We have an answer to that. So that's one I feel pretty strongly about. I don't think we tell people not to worry about that unless you're really overdoing it. You got more important things to worry about. The other thing we find is these people are consistent. They don't take weekends off or holidays off. They're pretty consistent. They stick with their plan all the time. And I think part of that in the book, we talk a lot about rituals and routines. Much of our behavior is routine. It's on pilot. It's automatic. You don't think about it. And so what we try to help people do is to say, you got a whole bunch of automatic behaviors that are taking you in the wrong direction. Let's replace those with automatic behaviors that take you in the right direction. You know, one of the things you talk about in the book, consistent with that is like, how can you redo your kitchen, right? So that it is. So it's doing exactly what you're talking about. So it can create habits. So it can just, you know, sort of just, it changes stuff in the background. So you know, it just, it becomes, it changes how your lifestyle is. And one of the things that, you know, I'll give a quick shout out to the book, which is that you guys did, especially in maybe the, the second half of the book, I think, where you give so many extremely practical examples, right? So in this conversation, we're kind of 30,000 foot over these things, but it's like here are very specific, you know, do this exact thing, right? And you give a bunch of different approaches and ways to do this in your life. Yeah. And it starts with simple things like if you know there are problem foods that you tend to overate, don't keep them in your house. Yeah. It's 10 o'clock at night. You might get in the car and go to the store, but the chances are much higher that you want. And by the way, what's an alternative? You may say, God, ice creams, what I really want. Well, is there something maybe not as attractive as ice cream, but still going to satisfy you? Thinking about putting food at higher shelves that's harder to get sounds simple. These things work. They really do. We talk about air fryer's wonderful tools to, you know, fry things without, you know, using fat and so forth. So we try to give a lot of practical tools. And again, our approaches, not every one of these may apply to you. So look them over, find ones that apply to you and put it into practice. So you said a couple of things in terms of folks who are successful weight maintainers. I want to dig just a little bit deeper on. So the first one you said was exercise and doing an hour a day or so of exercise or physical activity, I think you said. So what do you like? What counts as physical activity? So in the book, we recommend three, three types of being active. One is planned activity. We recommend that you set aside some time every day for intentional exercise. It can be intentionally going for a walk. It can be going to the gym. It's not whatever comes up. It's okay. Here's my time. I'm going to go and get my physical activity. And we recommend you do that every day. The second thing is more general lifestyle physical activity. Look for ways to be inefficient. You know, you're in a meeting five minutes early, rather than sit down, walk around a little bit. Look at, you know, that's why we like the pedometer, simple little pedometers. How do you get more steps in your life? You'll be surprised at how that can make a difference. And the third one is less sedentary time. Sit less. We spend so much of our day sitting. Anything you do other than sitting burns more calories. So try to look at the time you spend sitting and lots of people spend five, six hours a day sitting. Try to reduce that a little bit. So get some planned activity. Get in the habit, routine rituals of more lifestyle activity and consciously look at sitting. Stand up from your chair, walk around, get a standing desk, all kinds of things you can do. Anything is better than sitting. And you also talked about having a diet record, writing down things. So what, you know, so like for lots of folks when they're losing weight, they'll get an app or something like that that basically they can use to track their food. And so what I'm hearing you say is for weight loss, maintenance, success, it's not necessarily going that far. It's okay. You know, we're big, we're fine with those tools. You know, there are more and more apps and wearables and everything. Great. You don't have to do them like you can get a fit bed or an accelerometer. Simple pedometer will do too. It's up to you. If you're a high tech person, I tend to like the high tech stuff. Get it. That's fine. So simply a way to get some feedback on what you're doing. Use one of the apps if you want. Write it down yourself. Don't pay attention to total calories. They're very inaccurate on total calories. But pay attention to the types of food you're eating and are these foods that are on your plan. Interesting. Okay. Okay. So yeah, we welcome apps and wearables and all these things are going to make it easier to do this. So bring them on. And I'm thinking that one of the things that you said earlier, which is weigh yourself regularly, that one of the reasons you're doing that is because it's going to give you feedback on, oh, this, this, you know, something's going wrong here or this seems to be going great. Right. So it's not necessarily immediate feedback. Because as you said, the day to day doesn't really matter that much. But week to week does. Then by doing that regular way in yourself, you're going to get that feedback and then be able to adjust. Yeah. So there are two parts of that. One is knowing when you need to be concerned. So again, you go out to a party and the next day you're up five pounds. Is that something to worry about? Not necessarily. It's probably waterway. But look at the trends over the next few days is the trend stable is the trend up. And then what we really encourage people to do is to get what we call a take action weight. Let's say you're trying to maintain your weight at 170 pounds and you're saying, okay, I'm happy for it to bounce around a little bit. But when it gets up to 178, I know I need to do something. That's my early warning sign. And that can be two pounds, five pounds. It can be individualized. And it gives you a sense of when you should be concerned or not. And then in the book, we give you strategies for if that weight is above your take action weight, what actions should you take? And there are a number of different ways to do it. You have to be a little bit of a detective to figure out what works best for you. More times than not, it's on the food side, but not always. And one of the things that you talk about in the book that I really liked was you, and so we're not talking about GLP ones here, but more traditional weight loss approaches is that often that people can white knuckle their way through a diet for even for several months, which is actually pretty astounding when you think about it. That's pretty impressive, but you can't white knuckle the rest of your life. See, this is what one of the big messages that we've tried to do in our own research in the book is to get across the concept that weight loss maintenance is different from weight loss. It requires different skills. So weight loss, I mean, literally, it's like you can hold your breath. You don't go out to eat for a while. You don't go to parties. You're really good on, you know, you sort of take a time out from life, but weight loss maintenance, you can't do that. You've got to figure out how your new plan fits with everything else in life. You're going to have crises. Your spouse is going to get angry at you. You're going to have a loved one pass away. You're going to have this and this and this crisis and what you're going to have to do is figure out a way to live your life and maintain a lifestyle that keeps you where you want to be with your weight. I think that that's something that we just, we don't, I don't think about. And that like again, the idea that you can white knuckle it for several months, that's pretty damn impressive actually when you think about it. And that I think a lot of times folks feel like, well, I'll just sort of turn the volume down a little bit on this weight loss strategy. And that'll be that's my maintenance plan. And I think that that is how people that is think about it. So traditionally when we've run our programs, we produce weight loss and then we try to get people into weight loss maintenance. The problem has been no one ever felt like they were ready for weight loss maintenance. We would hear, I'll do that when I lose another five or 10 or 15 pounds. This is why Dan, we love the weight loss medications. They're doing the heavy lifting on weight loss. Now we can do our thing on weight loss maintenance and it's different. But what we have done, you're exactly right. The strategy's been going to diet and stay on that diet forever. Well, that has, we've got decades to show that doesn't work. What we are ready to do is help people with weight loss maintenance strategies. The drugs are doing the weight loss part of it. And this works, if you lose weight on your own with any other diet, what we give you in the book is a weight loss maintenance strategy. It doesn't have to be that you lost weight on the drugs. You can have lost weight anyway. This shows you how to keep the weight off. The other thing that we found that is probably the most important part of is what we call mind state. I can give you, I can tell you what to eat. I can help you do that. I can help you exercise. But with the wrong mind state, you're not going to stick with it. And that is so important. And that's why the therapist is listening. Oh my gosh. You can play a huge, huge role in people's success. So just before I get to the, before I jump on the mind state thing, just, what was I going to say? I just lost it. I was sure I lost it. Oh, okay. I'll just go to the mind state thing. So help us understand what, actually before this. So you, in the book, you talk about three weight gain profiles. Oh yeah. And I found this so helpful. Oh yeah. Yeah. Can you, can you talk about those three profiles? So they, you're going to help me here. The nonstop food seeker was the first one, wasn't it? Yeah. And this, we see this over and over and over. These are people that just, they can't avoid the overeating part. Food is really a problem for them. They go on a diet. They may do well with the diet. But once they go off the diet, they just can't. They just can't resist overeating these foods. That may be probably the most frequent profile we see. Food is the issue. And what we're telling those people, one whole part of the book is, what are the food strategies? And if you're a nonstop food seeker, that's where you need to concentrate. Not that the others aren't important for you, but look at where your major problem is and start there. And so then the other two were the sedentary sitter and the setback cyclor. Yeah, the sedentary sitter, I love this one because physical activity is my thing. And so they go on a diet, they lose weight, it's just fine, but they're sedentary. And so when you go on a diet, you lose weight, your energy expenditure goes down. So after you've lost weight, you need fewer calories to keep the weight off. Well, unless you're going to keep food restricting forever, you increase your food intake and you regain it. And it's so simple. And this is what happens to most people. And so it's like, why I'm so good at losing weight. And you know, it works. And I can go on these diets and snow problem for me resisting these. But without the increase in physical activity, you're always going to regain it because the body reaches a point where your intake and expenditure have to be equal. That's how you keep a constant body weight. And if you don't increase your physical activity, you're going to increase your weight to reach that equilibrium. And then the third one is the non-stop cyclor. And this is where Mind State works. Because people can do it, but what they really get in trouble is they can't deal with the challenges. You know, my colleague, Holly Wyatt, who's the co-author and way smarter than me, talks about, well, everybody goes through the swamp. The question is, do you get out the other side? And the non-stop side, they get stuck in it. And then they say, oh my gosh, I can't do that. I've blown it. And I'm going to start over and they regain the weight and then they do it again. And they lose the weight. They get it off, but they aren't able. They don't have the Mind State to help them be able to implement these strategies in their real lives. One of the things that I loved about the book and I think will fit for therapists, right? As a therapist, oftentimes you do some sort of formal or informal assessment of the problem, whatever's going on for the client, and then you have your treatment based on that assessment, right? And that's how I read these three categories in the book, right? It is what of these three, and they're not mutually exclusive, right? And you say that explicitly in the book, but what are these three is your bugaboo? Like what do these three is getting you most into trouble? And then here's a chapter for each one of them so that you have ways of thinking about and strategies and very specific behaviors that can help you if you fall in this category. Absolutely. And we each section of the solution deals with one of those. And again, you're exactly right. Find where your bugaboo is, but it doesn't mean you don't pay attention to the other two. One of them is likely going to be harder for you. And that's a good place to start and focus. But you have to do all three. You have to do the diet part, the physical activity part, and the mind state part. And it's therapists listening. Holly and I aren't therapists. And we put together what we've learned. And maybe some of the therapists will think some of our thinking is naive. But the hope is they will see where we're getting here. And maybe even take it to the next level. And they can probably explain some of this better than we can because they know the language and the terms. And I think what they will see is this hold it. We have, we talk about three mind states, Dan. We talk about a victim mindset, a victor mindset, and a voyager mindset. And too often we see this victim mindset. I can't tell you how many times we see that. It's, I'm overweight, but it's not my problem. You know, I have this biologated. And anything that goes wrong, they aren't taking responsibility. And they go, these are the people that come in and say, okay, I'm going to go through your program. It's probably not going to work because it's never worked before. Well, it's, they're going to be unsuccessful. The, um, Victor really learns that they can solve these problems. They can get through it. And, and a Victor mindset, mind state can be very successful. But the one we've really begun to see glimpses of is the voyager mindset. And this is someone that not just solves problems. It's almost their challenge by the problems in a positive way. It's like everything is a learning experience. This was a challenge I overcame it. But man, it's made me grow and become a bigger person. And it's, it's literally how you think about this. If you go into weightline, you stop the meds and you say, okay, I'm going to stop them. But gosh, I'm, you know, I'm going to regain my mind. I gain the weight. So I, the victim mindset, you're going to regain it. The victor, you can do it. You may, you may struggle a little bit more. But the, the voyager mindset state, and we've seen a few people with this. It's not just succeeding. It's actually immensely enjoying the process, the overcoming challenges, the success. And this is, this is really amazing that we can see people doing that. And I think the therapist can probably figure out maybe better than us how to help people move through that. But it's your whole, it's your whole approach to life. And what we're seeing is these people with the voyager mindset, they enjoy their success so much more that the, the victors, yes, they do it. They're happy with it. But one of the things we talk about in the book is rethinking success. Success really in the number on the scale. It's not what you want. You want a happy life. Okay. The number on the scale can be part of that. The health benefits that go along with it can be part of it. But part of it is engaging in life, going out and engaging with other people and being social and trying new adventures. That's the voyager mindset. And those are the ones that are not only going to succeed. They're going to really get true enjoyment out of success. That was one of the things in reading the book that I wanted to bring up is you have sort of, you know, the victim. I think that makes sense to everybody who's listening. Then you have the victor and the voyager. And in reading it, I was sort of like, you know, I read the, the, the, the, the, the victor one. I was like, okay, that seems about as positive as you get. Then I read the voyager one. I was like, oh, I see what this is adding. Like this is adding more of the looking at the opportunity, seeing the learning, seeing the, not just, all right, I did it and problem solving, but just more growth than I, I was sitting there and I was like, okay, so if this were me, how would I apply it to my life? And so what I did was I sort of said, okay, so you need to, if you need to increase physical activity, that's a bit of a burden, right? Then I said, okay, so let's take a voyager mindset for this. And what I did was I wrote down all of the physical activity types of things that I like to do that I don't do much of right now. You know, I have two younger kids not doing certain things as much and sort of said and sort of wrote down, okay. So what could I do? Well, I could join a running club. I used to be a part of a running club. I really liked that. Like, I wrote down, you know, I could start doing more cycling, which I really liked. A lot, I could join, you know, they're, you know, I really like playing ultimate frisbee. I should look at, so like all of a sudden it became this thing that's sort of like, all right, I could increase my physical activity to like, what are the things in life that I like that I'm not doing as much of for any number of practical reasons and reasonable reasons. And like, how can I use this to open those doors? And it was sort of like, I had this sort of like very, I mean, I was, I was literally sitting on the bus writing this down as I, I'm reading this and I had this like feeling of like enthusiasm and excitement for like, oh, then my life would be more fun if I did these things. It was just like a notable, like I went from a, you know, six to an eight, two, three, four. I love it. I wish we had had that example in the book. But and I'll go further and I'll challenge you. You said you had young kids think about how you can relate this to your family. How can you bring family and growth into what you've already done? That's the void your mindset is how can I not, why do I have to or why didn't it work? What are my opportunities? How can I engage more? How can I make life more enjoyable? And so the, the void your mindset, you're, you're always thinking about it. Not as a problem as an opportunity. And for you, it's like, oh my gosh, this made a difference. This is wonderful. What can I do more of? How can it enrich my life more? And the victim mindset is saying, yeah, but these things I know it's going to be hard. I don't have enough time. I'm not going to do it. It's going to, you know, I'm going to fail and then we're getting the way and I'm going to disappoint people. And it's amazing how prevalent that mindset is. Mm-hmm. Yeah. So one of the things, this is something I wanted to say earlier, that was when I lost my train of thought just in terms of the book. The way that I experienced the book was you talked a lot about the GLP ones and people's experience of that. And you talk specifically about moving, how to have weight loss maintenance, sort of following, you know, getting off of the GLP ones. But a lot of the weight loss maintenance strategies, ways of thinking about things, approaches, the way that I read it is. This is for anybody. This is not, you know, of course for this book, it's sort of written, you know, with some, you know, but it was very easy to see sort of the very practical, like, oh, this is how, this was just decades of, you know, practice and research on weight loss maintenance in a user-friendly book. That's how I read, you know, much of the book. Is that a reasonable way to experience it? That's exactly right, because what we're doing is we're combining two things. We're combining really the best research out there. We've done some of it ourselves. We're aware of the very, very best research on weight loss, weight loss maintenance. And so where possible, we really try to stick to the science. But the other thing that comes out and you got it is Holly is the best weight loss doc in the world. And she has decades of working with people. And it's like the, you know, the three profiles that comes from her doing hundreds of people and saying, "Of all the people I've seen, here are the buckets I've seen." So what we try to do is combine the best science with practical experience. And this is particularly Holly's experience of working with many, many patients. And again, there are some things in there that there's no science for. It's our best guess, but where possible, we work with the science or with her many years of experience in helping people succeed. And so first of all, for people listening, so I was on just before we chatted, I went on Amazon to see, you know, to see where the book's not, I'm correct, the book's not released yet, right? You can pre-order. Right. And it is. You can pre-order on Amazon. It'll be released on December 15th. And it's less than $30 US dollars. Yeah, we went to paperback in order to keep the cost down. We decided that would make it accessible to more people because we want people to read this. Whatever, you know, if you're planning on or have lost weight, this is a useful book for you. Whether you want to use GLP ones, whether you don't want to use GLP ones, whether you have or you're considering, I think this book will help you understand what it really takes to keep a long-term weight loss. And to be happy with it, you know, throughout the book, we talk about, it's not weight loss, it's happiness. And that's what we've learned from people. That's what they're after. And if you lose weight, and there are some people on the GLP ones, you lose weight, you don't feel good, you're not happy. This hidden success, success has got to be reaching a weight you're comfortable with, to weight that enriches your lifestyle, that makes you happier. One of the things that was great about the book was, again, it's just so practical. So in the chapter where you're talking about for folks who struggle with, you know, a sort of like the desire for food, you give such specific, uh, uh, ways of problems often. How do you problem solve going out to eat? How do you, you know, if you're feeling full? Here are the specific nutritional, uh, uh, components or macronutrients. Here's, you know, here's how much protein, here's how much fiber, here's how many calories, here's how many both. And that, you know, for a, you know, when you're eating breakfast for when you're having a snack, and then you go further and you say, here are five specific recipes down to the items that you can use to meet these criteria for breakfast or for a snack. And I just, it just was just like, oh, this is so bloody practical. I appreciate this so much. Well, thank you. And in fact, we're, um, we're in the process right now setting up a website where we can provide more of that, more recipes, the chance for people that are doing this together to communicate and interact and provide more services to help people. The book is a pretty good book for what to do. We want to give people more tools and more support for making sure they can do it. Well, and that was another thing that I was thinking as I was reading is sort of like are their communities, right? So particularly, particularly in sort of this online age, so much of this is problem solving, right? So I only, you know, problem solving. And that's our goal. Our goal is to create a community where people can share stories and successes and recipes where we provide some advice to, but a chance to have people talk about the problems that they're all experiencing and they can all relate to. Like for example, how do you deal with the food noise coming back? I'll bet you, if you ask a bunch of people that are doing it, you might come up with some creative stuff that we could never even think about. So that's one of the things that we want to do. Let's do allow it. We talk about people that are on the same journey, being able to communicate, share successes, failures, etc. So one of the things, so I just have a couple more questions and I'll let you go. So was there this book again? It's just so easy to read. It's so practical. Was it, you know, being somebody who writes a lot, so it's writing is hard. And was there a way that you guys sort of approached this so that you could be sure that it would be so accessible and beneficial to people? This is where you should have Holly answered this question because she's really good at what she says is, this is the book we've wanted to write our whole career and people have never been ready for it because people were never ready to focus on weight loss maintenance because they never succeeded at weight loss. So for us, it's the perfect time for us to write about what we spent our whole careers studying. Yeah. And that, I mean, it really feels like that. It really feels like, you know, here's decades and decades of sort of experience in this. And we're going to give it to you in a very digestible way, you know? That's what we try to do. Yeah, that's definitely how it feels. One question I always ask folks, because I always think it's interesting is what pushback if any of you think that I love it because again, my experience is if you're not getting pushback, you're probably not out in front enough. So I thought about this and there are a couple of ways. One is for whatever reason, there's suboptimum conversation between the nutrition community and the physical activity community. And some of the pushback is, well, physical activity, you just burn calories, you just eat more. It's really diet. And, you know, you're telling people after all this physical activity, what we really need to do is just focus on eating the right kinds of food. And I guess what we tried to do in the book and I wrote this chapter on what physical activity does other than burn calories. It burns calories, but physical activity optimizes your metabolism. When you stop moving your body, your metabolism suffers just like excess fat causes your metabolism to suffer. Not moving your body, not moving your muscles, using glucose, really causes your metabolism to be ineffective and exercise can fix that. So that's one of the pushbacks we get. And the other pushback is you always get people who say, no way, there is no way people are actually going to be able to maintain weight without drugs. You know, we've shown that people can't stick with diets, they can't stick with exercise. So you're out there telling to do this, but in the long run, unless they have the drugs, they're going to be unsuccessful. And I just don't believe that. So one of the things that what you just said, I just want to, the metabolism thing, this is something that was interesting, it was a little confusing. So, you know, we all know that when you exercising, you're burning calories. But what you're saying is that when you're exercising or when you're engaging in physical activity, that that's going to have a positive effect on your metabolism above and beyond just burning extra calories or above and beyond just gaining more muscle or whatever, that it's going to impact, have an impactful effect on your metabolism just in your life overall. Yeah. And, you know, I urge people to read that chapter. It's a little bit sciencey, but I think it'll be useful. But I'll summarize it in two ways. If you're exercising, you're going to burn more fat for anything you do during the day than someone that isn't. Even when you're not exercising, even when you're not exercising. You're going to burn more fat if you're an exercise than if you're a non-exerciser. The second thing is when you overeat and we all overeat occasionally, if you're an exercising fit individual, you're going to store a little less of that, not a lot, but a little bit. And over time, that's going to make a big difference. It's called adaptive thermogenesis. So if you overeat, you're going to store most of those calories. But if you have a fit metabolism, you're going to more of those extra calories, you're actually going to burn this fuel rather than store. And you don't see it. So, yeah. I'm sorry, go ahead. You know, it gives you a little advantage when you overeat and it's a small effect, but day in and day out, it's a big effect. Your metabolism is able to gear up a little bit more in response to overeating. When you're under-eater-over-eat, your metabolism changes in that direction. So your under-eat, your metabolism goes down, your over-eat, your metabolism goes up a little bit. If you're an exerciseer, that's going to go up a little bit more, causing you to store a little less of that excess. This isn't a huge effect. This is one of those small things that day in and day out, it gives you a little bit of advantage. Got it. So, when I eat that birthday cake or get a little over-enthusiastic at Taco Night, that my metabolism is going to turn up a little bit more when I overeat in that short term, which is going to help burn the extra-five calories. That's right. It's not going to burn all the extra. So, don't go overboard here. It's just going to give you a little bit extra calorie burning, a little bit extra calorie stored, a little less calorie stored. Jim, I can't tell you how much I appreciate this. This has been fun. I hope this has been useful. Again, you told me a lot of therapists listen and boy, I tell you, I hope they get engaged in this because I think they can really, really be important in helping people succeed whatever they decide to do with the meds. Yeah, I completely agree. I think it's something that is just not part of our training. It's a whole new world. It's going to get more exciting. I think having these meds, we have a wonderful new tool. I think the key is figuring out how to use the meds along with lifestyle to individualize success. That's a wrap on our conversation. As I noted at the top of the show, be much appreciated if you spread the word to anyone else who you think might enjoy it. Until next time.[Music]